Scholarship Application - South East USA
Thank you for applying for Jillina's BDEmpower Scholarship!

Applications are open until July 31, 2019

The recipient of this dance scholarship will receive tuition for 1 Middle Eastern or Tribal Fusion Bellydance Class per week for the months of September through June.

Scholarship Recipients must live in the South East Region of the USA (VA, NC, SC, GA, WV, KT, TN, AL, FL, MS, AR, LA, MD)

In order to maintain scholarship eligibility the recipient must:

Have 100% attendance rate for classes
Participate in a quarterly, online workshop with Jillina
Send a quarterly report of dance goals and progress

Instructions: Upon completing this application, an email will be sent to your instructor to request a letter of recommendation.

Please have 1 or 2 links to videos of the applicant dancing or performing to submit along with this application.

Email address *
Applicant Name (First Last) *
Your answer
Date of Birth *
Applicants must be between the ages of 12 and 17 on September 1, 2019 to qualify for the scholarship.
Phone Number *
Your answer
Address *
Your answer
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