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2025 FOOSA Tuition Assistance Application
Applicant's First Name
*
Applicant's Last Name
*
Applicant's Age
*
Instrument
*
Please Select
Flute
Oboe
Clarinet
Bassoon
Horn
Trumpet
Trombone
Tuba
Harp
Percussion
Violin
Viola
Cello
Bass
Main instrument
Permanent Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Best phone number at which we can reach the applicant
*
Please enter a parent or guardian's number if applicant is under 18
Responsible Party Email
*
Parent or guardian for applicants under 18
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Applicants claimed as dependents must complete the family information below. If you are not claimed as a dependent, you may skip this page.
Name(s) of Parent(s) or Guardian(s)
Family Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Number of persons living in household applying for financial assistance
Father's Occupation
Father is custodial parent?
Yes
No
Father's Phone Number
Please enter a valid phone number.
Mother's Occupation
Mother is custodial parent
Yes
No
Mother's Phone Number
Please enter a valid phone number.
Family Information (select all that apply) (note: separate financial information MUST be provided from both custodial and non-custodial parents)
Parents Married
Parents Divorced
Parents Separated
Single-parent household
Mother Deceased
Father Deceased
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All applicants must complete this page
2021 Adjusted Gross Income (Form 1040, line 11)
*
2022 Adjusted Gross Income (Form 1040, line 11)
*
Statement of Need
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A brief Statement of Need is required from all applicants. If you have submitted 2020 tax returns please describe how your family’s financial circumstances may have changed since 2020. Please provide additional information that may be helpful in our evaluation. Please discuss in detail any hardship circumstances that should be known such as medical problems, siblings in college, eldercare and extenuating circumstances concerning parent’s/guardian’s employment.
I hereby acknowledge and affirm that all of the information and documentation submitted as a part of this application is true and factual to the best of my knowledge, and understand that if discrepancies are found after most recent tax returns are submitted, this request and any tuition award previously offered may be adjusted or revoked by FOOSA. If necessary, I give permission to FOOSA to verify my employment, assets, and financial responsibility. I understand that I am responsible for any tuition balance that remains after tuition assistance amount has been applied. [Form to be signed by a parent or guardian if applicant is under 18]
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Printed name of person signing above
*
Date signed
*
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Month
-
Day
Year
Date Picker Icon
NOTE: MAXIMUM ASSISTANCE AMOUNT WILL BE ONE HALF OF TUITION FOR RELEVANT PROGRAM FOOSA PHILHARMONIC or FOOSA HALF-DAY. APPLICANT IS RESPONSIBLE FOR REMAINING COSTS. PLEASE CONTACT US EARLY IF YOU THINK YOU WILL NEED ADDITIONAL HELP OF ANY KIND.
All Tuition Assistance Requests must include (you will receive an email with upload instructions for these materials):
Completed application with Statement of Need (this form)
Copy of own or (if dependent) parents’/guardians’ 2023 Federal Tax Form 1040 OR
Copy of own or (if dependent) parents’/guardians’ 2023 return with a description in your Statement of Need of how your financial circumstances may have changed since 2022
Copy of own or (if dependent) parent/guardian’s most recent pay stub
Half-Day applicants may elect to show proof of Medi-Cal coverage
Email
example@example.com
Email
example@example.com
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