Student Scholarship Application Stingley Student Scholarship Name of teacher * First Name Last Name Email * Phone * (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country Student Information Name of student * First Name Last Name Date of Birth * MM DD YYYY How has your student expressed interest in music? * In what activities does your student currently participate? * Do they have an instrument in their home or daily access to one? * Who is your teacher and how long have you studied? * If you have not taken lessons before, please answer who your new teacher is. Letter of recommendation from a teacher, pastor, or other professional who knows or works with your child. * Please email a letter of recommendation to lewiscountymusicteachers@gmail.com Yes To be answered by the student: "I want to take music lessons because." * By checking yes, you are committing to meet the requirements by LCMTA and your teacher. * Yes, I agree Thank you!