Community Connections Scholarship Application
Community Connections is an instructional performing arts scholarship program for students ages 8-18 established through a partnership with local community partners. Its purpose is to provide performing arts training, leadership building and to seek out exceptional young residents in Southeast Raleigh who demonstrate a genuine passion for the performing arts. You must reside in Southeast Raleigh and provide proof of lower income status (ex: lunch money letter, 2017 tax return, income assistance information, etc.)
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Applicant's Name *
Your answer
Date of Birth *
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Age *
Your answer
How did you hear about the scholarship through Community Connections at Expressions in Rhythm Studio? *
Previous Dance/Drum Experience? *
If you answered yes to previous dance/drum experience, please state where and when.
Your answer
Class my child would like to take: *
Community Connections interview preference day and time *
Required
Why you are applying to the Community Connections program? *
Type your answer below
Your answer
Current school *
Your answer
Grade for the 2018-2019 School Year *
GPA *
Your answer
What are your plans after High School? *
This question is for grades 9-12
Your answer
How do you believe your acceptance into the Community Connections program will help your overall development? *
Your answer
What do you hope to accomplish through Community Connections at Expressions in Rhythm Studio? *
Your answer
Parent/Guardian's Name *
Your answer
Best Contact Number (Please include the area code) *
Your answer
E-mail Address *
Your answer
Medical Concerns/Allergies/Disabilities/Other *
Your answer
I currently reside in Southeast Raleigh. *
Please initial below
Your answer
I have at least a “C” or 2.0 grade point average in school . *
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Your answer
Assumption of Risk & Release of Liability- Please initial below *
I understand and acknowledge there is a risk of injury inherent in activities at the Studio and that personal injury and/or damage to property may result during participation in the Studio classes. I acknowledge that the Student is physically able to safely participate in the classes selected. I give permission for the Student to perform stunts, aerials, lifts or other activities, related to their respective class, at the Studio and in any and all performances. Parent/Guardian agrees to assume all risk associated with the Student's participation in instruction, rehearsal, performance, and related activities. In consideration of receiving instruction at the Studio, I hereby waive, release and discharge the Studio, its officers, directors, employees, agents, successors, sponsors, legal representatives and assigns, from all present and future claims and liabilities of any kind, whether for bodily injury, property damage, or other loss of Student or Parent/Guardian arising out of participation in Studio classes whether conducted on or off Studio premises.
Your answer
If accepted into Community Connections program, my child will attend a minimum of 90% of their class until June 2019. *
Please initial below
Your answer
If accepted into Community Connections program, my parent/guardian will pay 50% of monthly tuition fee until June 2019. *
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Your answer
If accepted into Community Connections program, my parent/guardian will provide my class attire. *
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Your answer
If accepted into Community Connections program, my parent/guardian agrees to pay applicable costume fees. *
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Your answer
Who helped you complete this application? *
I have read and understand the Scholarship Application for Community Connections at Expressions in Rhythm Studio and agree to abide by said policies. *
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