Art Center of the Bluegrass Scholarship Form
Scholarships for Art Center of the Bluegrass classes are awarded based on demonstrated financial need, availability of funds, and space in the requested class. To request a scholarship, please complete the form below and we will be in touch! Please note: completing this form does not guarantee acceptance into the class.
Contact Information
(Parent information, if requesting a scholarship for a child.)
Name *
Your answer
Address (with City, State, Zip) *
Your answer
Preferred Phone *
Your answer
Email Address *
Your answer
Which method is best to contact you? *
Student Information
(If requesting a scholarship for an adult, skip this section)
Name of Student
Your answer
Student Grade
Your answer
Student Age
Your answer
Student's School
Your answer
Does your child have any medical conditions, learning disabilities, special needs, or limitations that are addressed in their school program?
Your answer
Scholarship Request Information
Class/Activity/Camp for which you are requesting assistance *
Your answer
Cost of Activity *
Your answer
This is a scholarship request for: *
Materials and supplies for classes will be provided by the Art Center of the Bluegrass unless otherwise noted.
Required
Does the scholarship applicant receive any government benefits (Medicaid, SNAP, etc.)? Please describe. *
Your answer
If not, please briefly describe how this activity poses a financial hardship.
Your answer
Why do you/your child wish to participate in this activity? (Children are encouraged to compose their own response!) *
Your answer
How did you hear about this class/program?
Your answer
Agreements
Please check the boxes below, as appropriate.
Scholarships are entirely made possible by donations. May we include you/your child’s photo in publications highlighting the impact of the scholarship program? (Scholarship recipients are identified by first name only.) *
Would you be willing to be contacted by our Development Director about sharing your story with our donors? *
We understand that appropriate, respectful behavior is expected at all times while attending classes at the Art Center. We know that inappropriate behavior may result in student's dismissal from class and that there will be no refunds in the event of dismissal. *
Required
Participants in Art Center programs may be photographed by news reporters/photographers, staff members, or others. Registration constitutes permission to utilize photos and videos taken at the event for news, promotion and similar purposes unless you contact Art Center staff in advance of the event at info@artcenterky.org. *
Required
For student requests: As the parent or guardian, I will provide transportation or make arrangements for this student to attend class.
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