A A A

Scholarship Application

Full and partial scholarships are available based on financial need for VSA Nevada art workshops/camps for children or adults and on a very limited basis for other art related needs. Maximum amount is $100 per year. Any dollar amount you can contribute will help our scholarship dollars go further. You will be contacted regarding the status of your scholarship within 7 days. For VSA Nevada workshops, please indicate which workshop you are interested in taking.

Email: info@vsanevada.org, Fax: 337-6107, Mail: VSA Nevada, 250 Court St, Reno, NV 89501

==================================

Full and partial scholarships are available; any amount you can contribute will help our scholarship dollars go farther. You will be contacted regarding the status of your scholarship.

Participant's Name *

First Last
Parent's Name (required for children's workshops)
Age (required for children's workshops)
School (required for children's workshops)
Grade (required for children's workshops)
Date

Day Month Year
Address
City
State
Zip
Phone *
Employer
Work Phone
Cell #
E-mail: *

If application is for a child, please complete next section.

Please list class that you are interested in taking, including date and location.
Do you/your child have a disability?
# of people in your household
Household monthly gross income from employment *
List any other sources of household income or public assistance and monthly amount
Amount requested
Amount you can contribute

For a printer-friendly version to mail or fax, click here.

First	Last

Day	Month	Year