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Encore Creativity for Older Adults Financial Assistance Application
Encore strives to provide an affordable arts experience to everyone. Responses to this form will be used to assess what financial assistance we can provide.
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* Indicates required question
1. Name
*
Your answer
2. Address
*
Your answer
3. Email
Your answer
4. Telephone Number
Your answer
For which season are you requesting a Scholarship?
*
Your answer
Which Program area are you interested in joining:
Chorale
ROCKS
Camp
Encore University
5. If provided a payment plan, how many monthly payments would you need to pay the tuition?
2
3
4
I cannot pay the tuition in full
Clear selection
6. Household Income
*
Your answer
7. Household Size
*
1
2
3
4
Other:
8. Which of the following best describes your financial situation?
*
Student
Unemployed
Fixed income (social security, disability, etc.)
Other:
9. If you do not qualify for assistance, how much would you be able to realistically afford?
*
Your answer
Comments:
Your answer
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