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DHSSTP Scholarship Request Form (2022-2023)
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Date
MM
/
DD
/
YYYY
Student Name
Your answer
Grade
Your answer
Instrument
Your answer
Parent Name
Your answer
** Some Tutors may be willing to teach for community service hours.
Note that one (1) lesson per week is the maximum.
What price are you able to pay per lesson?
$15
$10
$5
$0
Other:
Clear selection
Parent Signature
Your answer
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