Individual Scholarships FORM | Midland Center For The Arts

Student Name *

Student Age *

Address (street, city, state, zip) *

City *

State *

Zip Code *

Email *

Phone *

Parent Name (if applicable) *

Class/Workshop Requested and Start Date *

Generally, the MAXIMUM amount granted will be limited to 50% of the total tuition cost. Amount of assistance Requested *

Describe the nature of your interest in this program and what you hope to accomplish by attending this class *

Reason for applying for the scholarship and additional comments *

Individual Scholarships