Kucinski Academy Scholarship Request

Date:

Student Name:

Parent Name:

Address:

City:   State/Province:   Zip/Postal Code:

Please Check all those that apply:

Applying for 30 minute private lesson scholarship

Applying for 45 minute private lesson scholarship

Applying for 30 minute pair lesson scholarship

Applying for 45 minute pair lesson scholarship

Applying for 30 minute group lesson scholarship

Applying for 45 minute group lesson scholarship

Please provide a short statement providing any details that may aid us in considering your request.

A copy of pages 1 and 2 of last year's tax returns should be mailed to:

or scanned and emailed to turnquist@morningside.edu.

Maximum scholarships will be awarded to families with a gross adjusted income of $25,000 and below on last year's tax return. Partial scholarships will be considered for families with an adjusted gross income under $40,000. Scholarships are awarded on a first-come, first-served basis. Maximum and partial scholarships are awarded per semester. Students on maximum scholarship will pay $5.00 for each 30-minute lesson and $7.50 for each 45-minute lesson. See registration form for payment of fees. Scholarships are not given for 60-minute lessons. For more information about scholarships, go to www.kucinskiacademy.com and click on FORMS and scroll down until you find the scholarship table.