Longmont Youth Symphony “Spreading the Harmony” Application Form Musician Name * First Name Last Name Instrument * Musician Address * Address 1 Address 2 City State/Province Zip/Postal Code Country School * Grade * Does Musician qualify for public school free/reduced lunch program? * Yes No Does Musician participate in their School music program? If not, please tell us why: * Private Lesson Info Private Teacher Name Private Teacher Email Private Teacher Phone (###) ### #### Private Lessons for how long? Are you applying for assistance with private lessons? * Yes No Parent/Guardian Info Parent/Guardian 1 Name * Parent/Guardian 1 Email * Parent/Guardian 1 Mobile * (###) ### #### Parent/Guardian 1 Occupation Parent Guardian 1 Employer Parent/Guardian 2 Name Parent/Guardian 2 Email Parent/Guardian 2 Mobile (###) ### #### Parent/Guardian 2 Occupation Parent Guardian 2 Employer Total Family Annual Income (before taxes) Other Children or Dependents and Ages Amount of Scholarship Requested $ Are you able to volunteer to help with LYS fundraising projects, Board of Directors, professional services or concerts? (Please be specific regarding what talents and time you can bring to LYS.) * Scholarships will be awarded on the basis of financial need; however, please use this space or attach a letter in which you explain any extraordinary circumstances that might help the Scholarship Committee understand your need. The Longmont Youth Symphony will hold all information in strictest confidence. * A copy of the first page of your most recent US Federal Income Tax Return is required. Please contact the Administrator (info@longmontyouthsymphony.org) for more details. Thank you!
