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Dear Parents,

Hunter Dance Center makes every effort to award financial aid when circumstances require it. We believe every child deserves the opportunity to enjoy the wide ranging physical and emotional health benefits dancing offers.  Hunter Dance Center staff reviews each application in confidence and makes award decisions based on the information you provide in this application.

Scholarship applications must be received no later than 3 weeks before the beginning of the session by email or fax. Please note that all scholarship applications require submission of the first page of the parents’ most recent 1040 US Tax Form, showing Adjusted Gross Income (AGI). Scholarship decisions cannot be made without the required tax information.

For any additional scholarship questions, please contact program director Tehillah Hartmann at tehillah@hunterdancecenter.com.

APPLICANT INFORMATION

Student First Name: ________________________ Student Last Name: ___________________

Home Address: ____________________________City, State: _______________Zip: _______

Student Email: ________________________ Student Birthdate: ________________________

Parent(s) Name: ____________________                Parent Email: ______________________

Parent Home phone:         __________________        Parent Cell phone: __________________

If student does not reside with both parents, please indicate with whom the student resides:

_________________________________________________


PROGRAM AND FINANCIAL REQUEST INFORMATION

Class Name(s): _________________________        Current Age: _____________

Listed program Fee:                                 $_______

Expected family Contribution:                         $________

Total Amount Requested:                         $_________

PARENT SECTION TO COMPLETE - PLEASE ATTACH ADDITIONAL PAGES IF NEEDED What are the reasons for requesting these funds? Please note any extenuating financial circumstances (medical, job loss, unusual expenses, etc) or significant family expenses, including college or childcare costs.







ADDITIONAL REQUIRED INFORMATION (TO BE ATTACHED TO APPLICATION)

Parent IRS Form 1040

DISCLAIMER AND SIGNATURE

By signing below, we are stating that the information outlined above is accurate, and that the amount of scholarship funds we are requesting is necessary in order for the applicant to be able to attend this program. We realize that funds for financial assistance are very limited and that receiving the full amount of funds requested is not guaranteed. In order to receive scholarship awards, participants must successfully complete the program, which means participants must attend, and complete the program without any attendance problems. Should the participants fail to complete the session for any reason, the student and his/her siblings will be ineligible for future scholarship funds.

Parent Signature: ________________________________

Date: __________________________________________


FOR OFFICE USE ONLY

Date received: ___________

Received by: ___________________

Scholarship award: $ ___________________

Reviewed by: ______________________

Approved by: _______________________