Tuition Assistance Application Form

Campus:

Hingham

Duxbury

Semester of Application:

Fall

Spring

Summer

Age:

Adult

Dependent/Child

Enrollment Status:

I am a returning applicant

I am a returning applicant adding another student/instrument/class

Returning applicants are eligible for funds for the full academic year and therefore there is no need to reapply in the spring. Returning applicants who have submitted tax returns within this calendar year need not re-submit them. If there is a change in your financial situation please indicate this in your cover letter.The newly added student/instrument/class will be considered as a first time applicant.

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:*

Student Enrollment Status:*

New

Returning

Adding

Instrument/Class:

Lesson Length (New Applicants can only apply for 30 minute lessons):

30 min.

45 min.

60 min.

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 live/s of the recipient/s 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*

WORK STUDY PROGRAM

Available to Summer Music Festival applicants only

Ensemble Librarian

Equipment/Set-up Assistance

Social Media Assistance

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