Fall Term 2026 Scholarship Application

Name of Parent or Legal Guardian

First NameLast Name
Name of Scholarship Recipient

First NameLast Name
Scholarship Recipient Birth Date

MonthDayYear
Date
Primary Contact Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Primary Contact Email Address
example@example.com
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Which course are you requesting a scholarship for which to attend?
View our Upcoming Classes on the A2AC Website for class information and additional course details.

Please Note: All materials are included in Youth & Teen Arts Classes.
First Preference - Course Selection
Second Preference - Course Selection
Third Preference - Course Selection

Income Information & Household Considerations
List the total number of individuals in your household-including yourself.
Number of Adults (including yourself) + Children
List the total number of individuals receiving income in your household.
Including Yourself
What is your Annual Household Income (before taxes)?
Be sure to include SSI, Disability, Public Assistance, and any unemployment pay.
If there are additional circumstances you would like us to consider regarding your income, please mention them here.

Reflection Form

Scholarship funding is made possible by our generous donors. Upon accepting a scholarship, you must agree to submit a form reflecting on your experience and what you may have valued or gained from it. This form is due within one week after the end of your class session and may be shared with current and prospective donors.
I understand that if a scholarship is awarded that I am required to submit a Reflections Form sharing what my child valued or gained from the experience. A member of the A2AC staff will reach out at the end of the term with further instructions.

I certify the information provided on this application is accurate and complete.

I understand that regular attendance and use of any awarded scholarship funds are required for future scholarship eligibility and that if I am awarded a scholarship, it may not be deferred to a different term.
Signature of Applicant (Or a parent or legal guardian for applicants under 18)
Should be Empty:

A2AC Arts Scholarship Application