Tuition Assistance Application

Financial Assistance Application

Please fill out a form for EACH student (kid, teen or adult) that you wish to receive assistance. If you need help completing this form, please contact our staff at 801.474.3796 or in-person at our office at 2900 S 300 W, South Salt Lake, UT 84115. If you are an adult, please include your information under parent/guardian.
Parent/Guardian Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is this the best emergency contact for this student?
If no, please put the name, phone number, and email address for the best emergency contact for this student.
Does your family qualify for the Federal Free School Lunch Program?
Yearly Household Income:
Household Size (Adults AND Children)
What percentage of tuition reduction are you requesting?
Could you contribute to tuition in other ways?

Other
Special Financial Considerations (please describe)
Student's Name

First NameLast Name
What program does this student want to be enrolled in?
What grade will student be going into this fall?
Student's Birthdate
What school are they attending?
Student's Race
Student's Ethnicity
Does this student have any medical issues/allergies/special needs that VAI needs to know about?
Photo Release: VAI may use photos of this student in marketing/grant proposal.
Proof of Income is required. *

Mail documents to:

Visual Art Institute PO BOX 522285, Salt Lake City UT 84152-2285

Document Checklist (submit at least two)

Free or Reduced School-Lunch

Copy of the 1st page of your most recent Tax Return

Current W2 Form

DWS Financial Benefit Statement

Employer Verification Statement

Housing Authority Annual Income Form

Other
BY ACKNOWLEDGING AND SIGNING BELOW, I AM ATTESTING THAT ALL OF THE ABOVE INFORMATION IS ACCURATE AND TRUE, AND THAT DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE. *
Should be Empty:

Financial Assistance Application