Scholarship Application

Scholarship Application

GNAT-TV Youth Media Programs - 2023
GNAT-TV believes that every student, regardless of socioeconomic status, should have the opportunity to enrich themselves in our youth media programming opportunities. GNAT-TV has a limited number of scholarships available for local residents within our service area with financial needs. Scholarships are determined by available funds for given programs and are based on total household members against total household income. Factors such as GPA, community involvement, and level of interest are not considered when determining scholarship eligibility. Preference is given to students who have not attended a GNAT-TV program before. GNAT-TV offers either full, 90%, 80%, 65%, or 40% scholarships, and is based on 300% 2023 National Poverty Guidelines. Our scholarship program is made possible by the support of local donors.
Parent Information:
Full Name*

First NameLast Name
Mobile No. :*

Area CodePhone Number
E-mail :*
Where the confirmation will be send to
Home Address :*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Household Yearly Income and Number of People in Household:*
Are you a full-time Vermont resident?*

YesNo
Do you own any properties outside of the state of Vermont?*

YesNo
Listed Student Information:
Full Name*

First NameLast Name
Birth Date*

MonthDayYear
Gender:*

MaleFemale
What school does the student currently attend?*
What grade is the student in?*
Which camp are you interested in?*
GNAT-TV awards scholarships to students who require financial assistance in order to attend. Please answer the following questions:
Have you ever received a scholarship in the past for GNAT-TV Summer Camps?*

YesNo
Do you have a relationship with anyone affiliated with Greater Northshire Access Television (GNAT-TV)?*

YesNo
If yes, please list their name(s) and affiliation with GNAT-TV:*
Applicant Signatures:
By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your scholarship application.
Parent Electronic Signature:*
By typing your electronic signature and submitting this form, I acknowledge that my electronic signature is as legally binding as my actual printed signature, and, further, that I am the parent and/or legal guardian of the "listed student" and over the age of 18.

GNAT-TV is committed to equal opportunity in employment and education. This station 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:

Parent Information:

Listed Student Information:

Applicant Signatures: