Instrument Request & Scholarship Application
Please fill out all the sections of this application to determine the amount of scholarship you will be requesting. Once this form is submitted, then pay to Goddard Middle School by check or cash sent in to Mr. Farrell.  To pay by credit card, contact the Goddard Bookkeeper.  Your student's instrument will be distributed once form and payment are both received.  If you will need to set up a payment plan, please contact Mr. Farrell directly.  
Mr. Farrell can be contacted through email at mfarrell@lps.k12.co.us or leave a voice mail at 303-347-7878.
Let me know if you have questions. Thank you.
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Email *
Student Last Name
Student First Name
Grade of student
Clear selection
Instrument student is requesting - $100.00 annual rental
Method Book (Required) 
Clear selection
Total is $110 - how much can the student's family pay at this time?
What amount is remaining?
$110 minus amount family can pay at this time
(This is the amount of scholarship funds being requested.)
Parent/Guardian Name
Parent/Guardian Phone Number
Parent/Guardian Email if different from above
A copy of your responses will be emailed to the address you provided.
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