Dance Academy Scholarship Application
Wellspring provides scholarships to low-income families and those suffering temporary financial hardship. Children and adults may both apply with first consideration given to youth applicants. Although Wellspring would love to award all applicants, scholarship funds are limited and not all requests can be filled.

The deadline to apply for scholarship for our 2017 - 2018 academic year is Saturday, August 26, 2017. Applications submitted after this date will not be considered. Please submit one application per person.

Applications will ONLY be reviewed after a photocopy of a supporting financial document has been submitted via email, fax, postal mail, or in person. Eligible documents are: most recent federal tax return, public assistance documentation, free/reduced lunch determination letter or proof of unemployment (photocopies only, will not be returned). You will receive a decision letter once your application has been reviewed.

Submit supporting financial document to:

Wellspring/Cori Terry & Dancers
359 S. Kalamazoo Mall, Ste. 204
Kalamazoo, MI 49007.

Fax to: 269-342-4245
Email to: kate@wellspringdance.org

Email address
Student's Name
Your answer
Age (if under 18)
Your answer
Street Address
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City/State/Zip
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Main Phone Number
Your answer
Secondary Phone Number
Your answer
School (if applicable)
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Grade (if applicable)
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School District
Your answer
Email Address
Your answer
Parent/Guardian Name (if applicant is under 18)
Your answer
For which class are you seeking a scholarship?
Have you previously taken classes at Wellspring?
Have you ever received a Wellspring scholarship?
Why are you interested in studying dance?
Your answer
Student lives with (if under 18)
Student is a single parent
How many people live in student's household?
Your answer
How many people under 18 live in student's household?
Your answer
Student's housing situation
Student's race/ethnicity (check all that apply)
Required
Applicant's annual household income
Applicant receives these government assistance programs (check all that apply)
Required
Please use the following space to provide any other reasons you or your child are in need of a Wellspring scholarship.
Your answer
By typing my name below, I commit to regular class attendance as a scholarship student. I understand that with two consecutive absences I forfeit my scholarship and Wellspring will seek another student to fill my space.
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