2022 Race4Rewards Scholarship Application Form

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Thank you for your interest in our Adam's World Club and Colors of Islam Club classes. Please complete this application form if you are unable to pay for the tuition and would like to be considered for a scholarship. There are a limited amount of funds available but we will do our best to provide assistance.

Email *

Date of Application *

YYYY

Name of Mother *

Name of Guardian (if different from parents):

Phone Number for Parent: *

Mailing Address for Parent: *

What program are you interested in? Please select all that apply *

Adam's World Club (ages 4-7)

Colors of Islam Club (ages 8-12)

Required

Household Income in U.S. Dollars *

$0-25,000

$25,000-50,000

$50,000-75,000

$75,000-100,000

$100,000+

Other:

Numbers of People in your Household *

What is the nature of your work income? *

Is there any special circumstances that should be taken into consideration? *

What type of scholarship are you requesting? *

100% free classes

50% discount of tuition

Other:

Name and Birth Date of Participating Child #1: *

Name and Birth Date of Participating Child #2:

Name and Birth Date of Participating Child #3:

Name and Birth Date of Participating Child #4:

Name and Birth Date of Participating Child #5:

Thank you for your scholarship application. We will review the details and get back in touch with you asap. If you have additional questions, please contact us by email at classes@soundvision.com.

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