Guyana Lutheran Music Academy 2016-2017 Scholarship Form Scholarships will be awarded at the beginning of each academic year. Recipients will be chosen based on the quality of their application and their financial situation.

In order to keep their scholarship, recipients will be required to: • Maintain 80% attendance or higher • Arrive to every class on-time • Participate for the entire 9 months • Have only one unexcused absence per quarter • Practice at home regularly and come to class prepared • Keep a positive attitude and participate as a model student Scholarship  Levels  or  Categories   100%  Off  i.e.  tuition-­‐$0/month   50%  Off  i.e  tuition=$1,300   Lutheran  Scholarship  (100%  Off)   First Name: ________________________________

Last Name: _________________________________

Please check one: 1st year student ____ 2nd year student ____ 3rd year student____ Please provide your household's average monthly income ($GD):____________________________________ Please state any special personal or family circumstances affecting your need for financial assistance. (For example: single parent income, family health needs, unemployment, etc.…) __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Please list any other activities you participate in (for example: after-school clubs, sports teams, community groups, church groups, etc.…). __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________

What do you plan on doing with your newly acquired musical skills? __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Why do you think you deserve or need a scholarship? (This is a good time to explain your work ethic, your passion for learning music, or anything else we need to know.) __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________

__________________________________________________________________________________________ Student Signature Date Parent/Guardian Signature (If under 16) Date