Merit-based Scholarship Form

Scholarship opportunities for students with exceptional artistic abilities seeking to further their art education.

Student Information

Applicant Name(Required)

First Last

Gender(Required)

Age(Required)

Please enter a number greater than or equal to 7.

Birth Date(Required)

Ethnicity (optional)

White

Black

Hispanic

Asian/Pacific Islander

American Indian/Alaskan Native

Other

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone Number(Required)

Email(Required)

Have you previously taken a class/workshop at GoggleWorks Center for the Arts?(Required)

If applicant is under 18, please provide the following:

Parent/Guardian Name

First Last

Current School

Current Grade

Course Selection:

Indicate the class/workshops you are interested in below. Please note that scholarship seats are offered on a first-come, first-served basis and depend on the current enrollment in class/workshop specified. Age restrictions are noted per class. Any exceptions must be pre-approved by the Programs Department.

First Choice(Required)

Start Date(Required)

Second Choice

Start Date

Third Choice

Start Date

Artistic Merit:

The following information is required to determine eligibility for scholarship acceptance. All information will be kept confidential. Please attach a letter of intent, maximum 200 words, answering the following: Why do you want to take a course at GoggleWorks and how will this scholarship award help you to do so? If applicant is 13 or younger – you may choose to complete the letter of intent OR attach a letter of recommendation from a teacher/mentor.

Letter of Intent/Recommendation(Required)

Max. file size: 128 MB.

Date(Required)

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Merit-based Scholarship Form

Student Information

If applicant is under 18, please provide the following:

Course Selection:

Artistic Merit:

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