Scholarship Form (YEAH! Programs 2017)

Student Name

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Which program are you applying for?

Rock Block (Murfreesboro, TN)
Rock Block (Nashville, TN)
Tennessee Teens Rock Camp (Murfreesboro, TN)
Tennessee Teens Rock Camp (Nashville, TN)
Southern Girls Rock & Roll Camp (Murfreesboro, TN)
Southern Girls Rock & Roll Camp (Nashville, TN)

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Date of Birth

Parent/Guardian Name

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Relation to Student

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Mailing Address

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City, State

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Zip Code

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Primary Phone

(Exp. 123-456-7890)

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Secondary Phone

(Exp. 123-456-7890)

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Email Address

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How did you hear about our programs?

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Which instrument does your student want to play?

FIRST CHOICE

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How much can you pay towards your student's tuition? A full tuition is $320.

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Is your student a recipient of the free and/or reduced lunch program at school?

Yes
No

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Are you a single-income family?

Yes
No

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I hereby certify to the best of my ability that all information on this application is valid and true.

I hereby certify to the best of my ability that all information on this application is valid and true.

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Which scholarship are you applying for?

The Ain't Afraid Scholarship
Gruhn Guitars Scholarship (Bass Guitar and Guitar Students only)
The Kelley Anderson Gear Scholarship
The Courtney Vickers Education Scholarship
The Anna Fitzgerald Community Scholarship

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The Ain't Afraid Scholarship honors the talent and bravery of our longest camper-turned-volunteer Jessi Zazu. Through her musical projects from Those Darlins to her new record (in progress now), she's an incredible musician and activist who has faced cancer head-on with positivity and bravery. She's got a mystic mind, fast fingers, and the biggest heart of all. Has music ever helped you through a hard time and inspired you to face your fears? For this scholarship, tell us how making or listening to music helps you tackle challenges head-on. (Southern Girls Rock Camp only, either location)