CMC Scholarship Form 2017-2018
Dear Prospective Scholarship Recipient and Parent/Guardian,

Thank you for your interest in the musical opportunities of The Chamber Music Connection (CMC). Please look at all of the subsequent pages for detailed directions in completing this application.

If you print and are hand writing this application, all parts of the Scholarship Application should be completed in clear and legible penmanship. There are separate pages for the student to complete, and separate pages for the parent/guardian to complete. Return all completed portions to the

Attention of The Scholarship Committee
c/o Chamber Music Connection
PO Box 831
Worthington, OH 43085-3563

*MOST PREFERRED WAY*
Or FILL OUT THE BELOW QUESTIONS AND SUBMIT VIA GOOGLE FORMS

Or email completed forms to cmconnectionadm@gmail.com

Applications must be postmarked by the following dates, depending upon the correlating session. Only one application per academic year (September-July) is required. However, the applicant must notify the artistic director or the administrative assistant, via e-mail, prior to each scholarship deadline, of the continued need, to be considered for ongoing scholarship awards. Notification of change in financial status will also be considered. It is the applicant’s responsibility to notify CMC, prior to each deadline, of the ongoing need for scholarship consideration throughout the academic year.

General CMC Programming:
Fall – September 1
Winter – December 3
Spring – March 27
Summer – June 1

David Wong Cover Tune Workshop due:
Winter – January 20

Competition Scholarship Consideration is due:
Winter - January 15
Spring - March 1
Summer - March 25

Any application not completed in its entirety and postmarked by the appropriate date will not receive consideration.
Thank you!
The Scholarship Committee
The Chamber Music Connection

Email address *
1. The Chamber Music Connection is a non-profit organization. Realizing that all non-profits benefit from an individual’s time, treasures, and talents, how would you, as a parent of a CMC Scholarship Student, plan to give back to the organization? (not limited to those listed below): *
TO BE COMPLETED BY A PARENT/GUARDIAN
Required
2. Please share other activities in which your student is involved and whether money/scholarship has been awarded for their participation. *
TO BE COMPLETED BY A PARENT/GUARDIAN
Your answer
3. Please share any information that could help the Scholarship Committee reach a decision regarding your request for scholarship money. *
TO BE COMPLETED BY A PARENT/GUARDIAN
Your answer
Mailing Address: *
TO BE COMPLETED BY A PARENT/GUARDIAN
Your answer
Parent/Guardian E-mail: *
TO BE COMPLETED BY A PARENT/GUARDIAN
Your answer
Cell Phone Number: *
TO BE COMPLETED BY A PARENT/GUARDIAN
Your answer
Home Phone Number: *
TO BE COMPLETED BY A PARENT/GUARDIAN
Your answer
Family Gross Annual Income: *
TO BE COMPLETED BY A PARENT/GUARDIAN
Your answer
Family Investments/Savings (excluding primary residence): *
TO BE COMPLETED BY A PARENT/GUARDIAN
Your answer
Thank you for completing your portion of this application. We sincerely appreciate your willingness to complete this form and we ask, in addition to signing this page, that you read and sign your student’s obligation page as well. With appreciation,
 The Scholarship Committee The Chamber Music Connection *
TO BE COMPLETED BY A PARENT/GUARDIAN
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Parent/Guardian Signature *
TO BE COMPLETED BY A PARENT/GUARDIAN
Your answer
TO BE COMPLETED BY THE SCHOLARSHIP APPLICANT *
1. For this section, it is greatly appreciated by the Scholarship Committee to receive thoughtful and well-structured responses.
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Student Name: *
TO BE COMPLETED BY THE SCHOLARSHIP APPLICANT
Your answer
Student Date of Birth: *
TO BE COMPLETED BY THE SCHOLARSHIP APPLICANT
Your answer
Student Home Address: *
TO BE COMPLETED BY THE SCHOLARSHIP APPLICANT
Your answer
Student E-mail: *
TO BE COMPLETED BY THE SCHOLARSHIP APPLICANT
Your answer
Student Cell Phone Number: *
TO BE COMPLETED BY THE SCHOLARSHIP APPLICANT
Your answer
Grade in School: *
TO BE COMPLETED BY THE SCHOLARSHIP APPLICANT
Your answer
Current School: *
TO BE COMPLETED BY THE SCHOLARSHIP APPLICANT
Your answer
Primary Instrument: *
TO BE COMPLETED BY THE SCHOLARSHIP APPLICANT
Your answer
Secondary Instruments (if necessary):
TO BE COMPLETED BY THE SCHOLARSHIP APPLICANT
Your answer
Years of Study (primary instrument): *
TO BE COMPLETED BY THE SCHOLARSHIP APPLICANT
Your answer
Music Instructor(s) (i.e. Private Teachers and School Directors): *
TO BE COMPLETED BY THE SCHOLARSHIP APPLICANT
Your answer
Other Activities/Interest: *
TO BE COMPLETED BY THE SCHOLARSHIP APPLICANT
Your answer
2. Please write a brief essay as to why your involvement in CMC is important to you as a musicians and a person? *
TO BE COMPLETED BY THE SCHOLARSHIP APPLICANT
Your answer
3. Who do you consider to be your musical influences? *
TO BE COMPLETED BY THE SCHOLARSHIP APPLICANT
Your answer
4. Obligation Page
(to be signed by student and parent/guardian) If scholarship money is awarded to you as a student of CMC, we ask, as the Scholarship Committee, that you consider the following as giving back to The Chamber Music Connection: *
TO BE COMPLETED BY THE SCHOLARSHIP APPLICANT & PARENT/GUARDIAN
Required
STUDENT: By signing below, you acknowledge that you have read and agree to the above provisions, and that the student has completed the student portion of the application to the best of his/her personal ability. *
TO BE COMPLETED BY THE SCHOLARSHIP APPLICANT
Your answer
Date of Signature: *
TO BE COMPLETED BY THE SCHOLARSHIP APPLICANT
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PARENT/GUARDIAN: By signing below, you acknowledge that you have read and agree to the above provisions, and that the student has completed the student portion of the application to the best of his/her personal ability. *
TO BE COMPLETED BY A PARENT/GUARDIAN
Your answer
Date of Signature: *
TO BE COMPLETED BY THE SCHOLARSHIP APPLICANT
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A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
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