Anthony & Patricia Stark Scholarship Application

Anthony and Patricia Stark Scholarship
Making Music Available to All Children

The Anthony and Patricia Stark Scholarship was created to provide scholarships to Copper Country Suzuki Association students

Scholarship Criteria:
- The recipient must be an elementary or middle school student
- Participation in a Suzuki string program (or another string program)
- Financial need
The application should be filled out by a parent/guardian.

Any questions can be directed to mail@keweenawgives.org or call or text 906-482-9673.
1. Personal Data

Tell us about the student
Student's Name*

First NameLast Name
Parent/Guardian Name:
Parent/Guardian Name*

First NameLast Name
Other Parent/Guardian Name

First NameLast Name
Other Parent/Guardian Name:
Contact phone number :*
Parent's E-mail :*
(Where the confirmation will be sent )
Home Address :*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
2. School Information

Tell us about your education
Name of School Student is Currently Enrolled in:*
Student grade:*
i.e. 3rd grade, 6th grade, etc.
Is the student a member of the Copper Country Suzuki Association?*

YesNo
What instrument does the student play?*
Years of study:*
3. Financial Information

Help us understand your financial situation
Annual family income:*
Are there any special financial situations you'd like the Selection Committee to consider?*
4. Applicant's E-Signature
By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are the parent/guardian of the student for which you are completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please save for your records and retain as verification of your application.
E-Signature:*
The Keweenaw Community Foundation is committed to equal opportunity in education. The Organization does not discriminate in any program or activity on the basis of race, color, religion, gender, age, national origin, disability, marital status, or any other protected class.
Should be Empty:

Anthony and Patricia Stark Scholarship

1. Personal Data

2. School Information

3. Financial Information

4. Applicant's E-Signature