Foundation for Creative Achievement Application Form

Please check the scholarship for which you are applying:

Piano

Strings (Violin, Viola, Cello)

Voice

Preferred Campus:

Hingham

Duxbury

Parent/Guardian Contact information 1:

Parent/Guardian name:*

First

Last

Address:*

Street Address City State / Province / Region Postal / Zip Code

Primary Phone:*

Area Code

Phone Number

E-mail:*

Employer's name:*

Occupation:*

Parent/Guardian Contact information 2:

Parent/Guardian name (contact 2):*

First

Last

Address (contact 2):*

Street Address City State / Province / Region Postal / Zip Code

Primary Phone (contact 2):*

Area Code

Phone Number

E-mail (contact 2):*

Employer's name (contact 2):*

Occupation (contact 2):*

Student Information 1:

Student Name:*

First

Last

Date of Birth:*

Previous/Additional Studies at SSC (class/instructors/#of years)

Please tell us why you think the programming you are applying for funds towards will impact the recipient and if there any other circumstances SSC should take into consideration when reviewing your application?

Please email your most recent tax documents to: tuitionassistance@sscmusic.org or mail to: P.O. Box 1523, Duxbury, MA 02332

I understand that South Shore Conservatory seeks to award financial assistance to those whose needs are greatest and does not discriminate in matters of race, color, sexual orientation, national or ethnic origin. To the best of my knowledge, the information given on this application is correct. All financial information will be regarded as strictly confidential by the Financial Aid Committee. The Committee reserves the right to ask for additional support information.

Parent/Guardian Signature:*

First

Last

Relationship to Student: *

Date*

Recaptcha Word Verification: