On Your Feet Scholarship Application

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PURPOSE

This Scholarship was created by DTAN to help children in financial need participate in dance classes

PRIVACY & CONFIDENTIALITY

Information provided in this application is being collected for the purpose of administering the DTAN scholarship. This information will only be disclosed to DTAN members who will need the information to process the application.

Section A: Guidelines for Application

Funds are rewarded for dance class fees, associated attire, and transportation (if applicable).

Funding is for a full dance season by an active DTAN member (list of members is available online).

Recipients must be between the ages of 3-18yrs for the duration of the proposed season.

Applications must be completed in full.

Section B: Applicant Information

Application Name: *

Applicant Date of Birth: *

YYYY

Applicant Address: *

Applicant's Parent/Guardian's Name: *

Applicant's Parent/Guardian's Phone Number: *

Applicant's Parent/Guardian's Email: *

I, the parent/guardian listed above, am aware of this application and confirm that the information provided above is correct: *

Yes

Section C: Funding Request

If looking at multiple options for dance studios to attend, please list your 1st choice, 2nd choice and 3rd choice below. Please make sure to fill in the required information for all choices you list.

Dance Teacher/Studio (please list 1st choice, 2nd choice and 3rd choice if applicable): *

Choice of Discipline (please list for your 1st choice, 2nd choice and 3rd choice if applicable): *

Cost of Program for full dance season fees (please list for your 1st choice, 2nd choice and 3rd choice if applicable): *

Approximate cost of uniform, footwear and recital costume (please list for your 1st choice, 2nd choice and 3rd choice if applicable): *

Section D: Dance History

Is this your first time participating in dance? *

Yes

If no, how many years has the applicant been participating in dance classes?

Was it funded by an organization? *

Yes

If yes, which organization?

Section E: Transportation

Is transportation required? *

Yes

If yes, please list the distance from home to dance and cost of taxi (round trip) for each of your studio choices:

Section F: Financial Questions

How many children are in your family: *

What are the adults' employment situations in your family? *

Are the parents involved with the child's activities? Please elaborate. *

Is the child currently involved in other organized activities? Please elaborate: *

Has the child been involved in organized activities in the past? Please elaborate: *

What is the family's means of transportation? *

Section G: Candidate Essay

Applicant is to write a short essay on why they wish to take dance classes. If the applicant is under the age of 10, this can be written by a parent or legal guardian on their behalf. *

Section H: References

Please provide two references who can attest to your specific situation. They cannot be a family member or close friend. Only one reference can be from a dance teacher. Recognized sponsors: physician, social worker, school teacher, guidance counsellor, therapist, clergy member, etc.

Please have your references fill out this form. Your scholarship application is not complete without the references.

I, the parent/guardian, authorize the references to release personal information to DTAN as required for the program placement and scholarship. *

Yes

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