Student First Name *

Student Last Name *

Program Applying For *

If Stage School, please list specific classes:

Student Age *

Grade in School *

School Student Attends *

Parent/Guardian 1 Full Name *

Parent/Guardian 1 Phone *

Parent/Guardian 1 Email *

Parent/Guardian 2 Full Name *

Parent/Guardian 2 Phone *

Parent/Guardian 2 Email *

Why are you applying for a scholarship? *

Has your family received a CMT scholarship in the past? * Yes No

If so, what was the date, name of program, and amount of scholarship?

As a thank you to any potential scholarship, can we contact you about volunteering opportunities to give back to our organization? Yes No

My household is located in the CITY of: *

My household is located in the COUNTY of: *

Number of Dependent Children: *

Yearly Family Income: *

Number of Income Sources (example: 1 full time or 1 full time and 1 part time): *

Total Number of People Living in the Home *

Describe any unusual financial obligations: *

Is anyone in the household eligible for food stamps? * Yes No

Is your household a participant in the Housing Choice Voucher (section 8) program and/or a Pubic Housing resident? *

Type your initials to verify you understand that CMT may ask for proof to verify the information in this section. *

If a partial scholarship is offered, will you consider paying a reduced rate? * Yes No

If so, how much? Stage School - 25% of monthly class tuition Stage School - 50% of monthly class tuition Stage School - 75% of monthly class tuition School Year Show/Summer Camp - 25% of total tuition School Year Show/Summer Camp - 50% of total tuition School Year Show/Summer Camp - 75% of total tuition

Additionally, I recognize that any application that has not been FULLY completed, will not be considered. (Type your initials to verify you understand.) *

Please type Parent/Guardian name as a digital Signature *

Date of submission: *