Tuition Assistance Application

Financial Information and Statement of Need

Individual Lessons
Has a job loss or loss of income due to COVID-19 affected your need for assistance?*

YesNoOther
Please indicate the amount of tuition assistance you are requesting.*
In an effort to help as many people as possible, we ask that you make a good faith request for the amount of assistance that would make it possible for you to enroll in your program. If you have any questions please contact the office.
Please write a brief statement of need including any other information that you think would be useful. Applicants who are requesting tuition assistance for individual lessons should submit the first 2 two pages of their most recent tax return (see next question). If you are not required to submit taxes (or do not have recent tax returns) please elaborate here.*
Please submit a copy of your most recent tax return (first two pages only, no schedules). You may submit your form electronically or mail a copy of your tax return to Upper Valley Music Center at P.O. Box 826, Lebanon NH, 03766. Please indicate below.*

I will upload my tax return.I will mail my tax return.
Upload a copy of your most recent tax return, without any schedules.

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Financial Information and Statement of Need

Group Classes
Has a job loss or loss of income due to COVID-19 affected your need for assistance?*

YesNoOther
Adjusted Gross Income from your most recent federal tax return:*
Number of family members listed on your most recent federal tax return:*
Please indicate the amount of tuition assistance you are requesting.*
In an effort to help as many people as possible, we ask that you make a good faith request for the amount of assistance that would make it possible for you to enroll in your program. If you have any questions please contact the office.
Please write a brief statement of need including any other information that you think would be useful.*

Adult Work Study
Qualified Work Study participants receive credit that can be applied to their tuition or the tuition of an immediate family member. Opportunities range from supporting events to music library organization to building maintenance. Let us know below if you have a skill or talent that you think would be an asset to UVMC. Availability of work study funds is limited.

Student Information
Name of Student 1*

First NameLast Name
Birthdate of Student 1*
Name of Student 2 (If Applicable)

First NameLast Name
Birthdate of Student 2 (If Applicable)
Additional Students and Ages (if Applicable)
Contact Information
Name of Parent/Legal Guardian (If Applicable)
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Type your name below to electronically sign your application.*
Thank you for your application! We look forward to making music with you and having you as part of the UVMC Community.
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Upper Valley Music Center Tuition Assistance Application