Please indicate the program/s for which you are requesting assistance. *
Parent/Guardian Name A *
Your answer
Parent/Guardian Name B
Your answer
Email (please put two emails if more than one caregiver should be contacted for all communications). *
Your answer
Home address, City, State, zip code
Your answer
Child's Name *
Your answer
Total annual household income (salaries, interest, investments, alimony, social security, public assistance). If there is more than one household, please give income for both. *
Your answer
Explain any extraordinary financial circumstances that might impact on the above: *
Your answer
The maximum amount I can pay per month is: *
Your answer
If a Scholarship is awarded, you and/or your student(s) agree to participate in work/study and volunteer opportunities. For example, assist at Vanguard shows and events (Front of House, community events, assisting Instructors) and participate in fundraising. *
Required
If your answer is yes, please let us know areas of interest/expertise that you/your child might like to explore.
Your answer
I hereby certify that the information provided is true and accurate. I understand that I may be asked to provide proof of income by submitting a copy of last year's federal tax return. *
Required
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