Scholarship Application
2024/25
Student Name
*
First Name
Last Name
Student Age (at time of application)
*
Instrument(s)
*
Teacher(s) Name(s)
*
Teacher(s) Email(s) so we may send them a Recommendation Request
*
YouTube link of performance of applicant's polished piece approved by their teacher (if you have one).
Alternatively, if you have a video file of a teacher-approved polished piece, you may upload it here:
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When did student first enroll at the Suzuki Music Institute of Dallas?
*
Primary Parent's Name
*
First Name
Last Name
Primary Parent's Email
*
example@example.com
Primary Parent's Preferred Number
*
Please enter a valid phone number.
Primary Parent's Occupation
*
Primary Parent's Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Secondary Parent's Name
First Name
Last Name
Secondary Parent's Email
example@example.com
Secondary Parent's Preferred Number
Please enter a valid phone number.
Secondary Parent's Occupation
Secondary Parent's Address (if different from above)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parents' Marital Status
*
Please Select
Married
Remarried (after being widowed or divorced)
Never married
Divorced or Separated
Widowed
Unmarried and both legal parents living together
Other
Please specify marital status
Head of Household Earnings
*
Spouse's Earnings (if taxes are filed separately)
Total Household Annual Income
*
Upload FIRST TWO PAGES of your most recent filed Federal Tax Return:
*
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# of Children in Family
*
# of Children Taking Lessons at SMID
*
Current lesson length on primary instrument
*
Please Select
30 minutes
45 minutes
60 minutes
80 minutes
Current lesson length on secondary instrument (if applicable)
Please Select
Which Group Class did the student participate in (instrument and class name)?
*
Did the student participate in Kodomo Music?
*
Please Select
Yes
No
Did the student participate in any fundraisers or outreach concerts?
*
Please Select
Yes
No
Which fundraisers or outreach concerts did the student participate in?
List all volunteer activities in which the student participated during the academic year at SMID
*
Did you receive financial aid this past year from SMID?
*
Please Select
Yes
No
How much financial aid did you receive?
Predicted lesson length for next year?
*
Please Select
30 minutes
45 minutes
60 minutes
80 minutes
Predicted lesson length of secondary instrument for next year (if applicable)?
Please Select
30 minutes
45 minutes
60 minutes
80 minutes
Which Group Class will the student be participating in next school year?
*
LETTER OF APPEAL: Please indicate any special circumstances which bear on your need for financial assistance.
*
Statement of Intent
*
I have discussed the Student Statement of Intent with my child and they understand their obligations and commitments.
Primary Parent's Signature
*
Secondary Parent's Signature
Submit
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