The Community Music School of the Piedmont

The Community Music School of the Piedmont
P.O. Box 442, 9110 John Mosby Hwy.
Upperville, VA 20185
ph: 540-592-3040
piedmontmusic@aol.com

Scholarship Application

This is for tuition aid application records only. Providing the information on this form does not register you for lessons or classes. A separate registration form must be submitted.

*Student's Name:

Student's Age (if under 18)

Current Grade:

*Home Phone:

*Parent/Guardian's Name:

*Employer:

*Work Phone:

Parent/Guardian Name:

Employer:

Work Phone:

*Email:

*Mobile Phone:

*Contact Preference:

Parents' Marital Status:

*Student Lives with:

*Street Address:

*City:

*State/Province:

*ZIP/Postal Code:

Which CMSP location do you prefer?

*Are you a new or returning CMSP student? If returning, did you receive financial aid last year?

New student Returning student-no, we did not receive financial aid last year Returning student-yes, we did receive financial aid last year

*For what type of instruction are you seeking aid?

Private lessons Group class Workshop

*What instrument(s) would you like to study?

If you know with whom you would like to study, please indicate that above as well.

Preferred Lesson Length:

30 minutes 45 minutes 1 hour

Applicant's Musical Achievements:

Please include number of years of private study to this point, on what instrument, any awards etc.

*Number of adults in your household:

*Number of children in your household:

*Total yearly family income:

*Total monthly family expenses (please specify rent/mortgage, loan(s), and any other expenses you want us to consider.):

Submit Your Message:

Thank you for applying. We will be in touch shortly. If you have any further questions, please email us at piedmontmusic@aol.com.

Agreement:

I understand that a Tuition Aid award is contingent upon the student's progress and full participation and cooperation in all lessons, classes and ensembles for which the student is registered. (Please note that tuition aid is not a cash award, but tuition remission for lessons and required classes.) I certify that the information provided on lthis form and all accompanying documents is correct and understand that false, misleading and/or incomplete information is grounds for con-consideration or forfeiture of all Tuition Assistance awards.

The Community Music School of the Piedmont
P.O. Box 442, 9110 John Mosby Hwy.
Upperville, VA 20185
ph: 540-592-3040
piedmontmusic@aol.com

Scholarship Application

More Information