EILEEN J. SCHILLING MEMORIAL SCHOLARSHIP AWARD APPLICATION FORM   Instructions: This form must be completed by a responsible adult applicant on behalf of a student aged 7-18 for financial need based scholarship for classes and/or productions at the Music Theatre of Connecticut. Scholarships are not available for private lessons. Please complete all fields below.   APPLICANT INFORMATION   Name of Student * Applicant Name * Relation to Student * Age of Student * Birth Date of Student * Address * City * State * - - Choose One - - Alabama Alaska Arizona Arkansas California Colorado Connecticut D.C. Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code * Home Phone * Cell Phone Applicant/Parent E-Mail Address * Employer of Applicant * Number of Persons in Household * Is student currently enrolled at MTC? * Select: Yes No If so, in which class/es? Has student ever received an MTC Scholarship before? * Select: Yes No If so, which academic year/s? If so, what amount/s were scholarship/s? What factors make this student more likely than most to have a positive and successful experience as a student at Music Theatre of Connecticut? *   APPLICANT’S FINANCIAL INFORMATION   Annual Income * Additional Income Sources (savings, investment income, etc.) Monthly Rent or Mortgage payment * Other Major Family Expenses? (Please explain.) Please attach most recently filed IRS 1040, 1040A or 1040EZ *   CERTIFICATION (Please initial each of the following upon completion)   I have attached my most recently filed IRS 1040 (or 1040A or 1040EZ) as required. *   I understand the application deadline is September 30 for the following Academic Year. I understand that I will be ineligible for an Eileen J. Schilling Memorial Award if this completed form and required attachments are not received by MTC by the deadline. *   I have answered all the questions on this form. There are no blanks. *   IF AN INTERVIEW IS REQUIRED TO RECEIVE AN EILEEN J.SCHILLING MEMORIAL AWARD, I understand that MTC will contact me if I need to reserve an appointment time. *   I have read and completed this form and understand that the form and attachments must be received by the Music Theatre of Connecticut before the deadline stated above and that I may be required to attend interview before that deadline in order for the above named student to be considered for an Eileen J. Schilling Memorial Award. I also understand that if an Eileen J. Schilling Memorial Award is awarded, it may be revoked for lack of student’s satisfactory progress. I also understand that an Eileen J. Schilling Memorial Award only covers a portion of tuition costs and I will be responsible for all remaining tuition, registration and performance fees, where applicable, should I accept Eileen J. Schilling Memorial Award. *