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Tuition Assistance Application
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Date
MM
/
DD
/
YYYY
First Name
*
Your answer
Last Name
*
Your answer
Date of Birth
MM
/
DD
/
YYYY
Email
*
Your answer
Phone
Your answer
Current Address Street
Your answer
Current Address City
Your answer
Current Address State
Your answer
Current Address Zip
Your answer
US Citizen?
If Visa, please provide type and number
Yes
No
Other:
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Household Income Range
Under $25,000
$25,000 - $49,999
$50,000 - $74,999
$75,000 - $99,999
$100,000 - $199,999
$200,000+
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What Jazz Night School offering(s) are you enrolled/enrolling in?
Your answer
Jazz Night School gives careful consideration to the financial needs of applicants as well as academic achievement. Please explain why you are requesting to be considered for Tuition Assistance.
Your answer
How much Tuition Assistance do you need to enroll in this session?
Your answer
How much tuition can you contribute for this session?
Tuition Assistance + tuition payments should equal normal tuition for enrollment - Combos $495, Classes $395
Your answer
I certify that the information in this application is correct to the best of my knowledge. I agree to miss no more than one class per session unless approved by my instructor and I agree to an evaluation of my process by my instructor at the end of the session if needed. I agree to abide by Jazz Night School policies. If I do not meet these criteria, I understand that I will not be eligible for future Tuition Assistance. I have read this statement and agree.
*
I Agree
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