Financial Aid Form

Student Financial Aid Request Form for School Year 2022– 2023

Student Number 1

Name of Student:

New

Returning

Birth date (if 4 – 18yrs.):

New

Adult

School

Grade Level

What instrument(s) is the student interested in learning?

Has student received financial aid from BSMA before?

Yes

Student Number 2

Name of Student:

New

Returning

Birth date (if 4 – 18yrs.):

New

Adult

School

Grade Level

What instrument(s) is the student interested in learning?

Has student received financial aid from BSMA before?

Yes

Student Number 3

Name of Student:

New

Returning

Birth date (if 4 – 18yrs.):

New

Adult

School

Grade Level

What instrument(s) is the student interested in learning?

Has student received financial aid from BSMA before?

Yes

Parent/ Guardian’s Name:

Relationship

Occupation:

Employer:

Home Address:

City:

Zip:

Home/Cell Phone:

Work Phone:

Total Number in family:

City of Cleveland Ward # (if applicable):

PLEASE FILL IN ALL QUESTIONS BELOW. DO NOT LEAVE ANY SPACE BLANK!!!!!

Current Household Monthly Income for 2022: $

(Please include all taxable & non-taxable income in your calculation)

Total Household Income for 2021:

Monthly

mortgage/rent: $

If child is in private school, what is your tuition cost for the school year? $

Please indicate the amount you can afford to pay per weekly class/lesson: $

(Please Note: Individual one-on-one lessons are currently $16.20 - $ 18.00 per lesson, depending upon the instructor)

Required - Please submit proof of income by mailing (Registrar, Broadway School of Music & the Arts, 5415 Broadway Ave., Cleveland, OH 44118); faxing (216-641-7431;) or emailing (registrar@broadwayschool.org) nonreturnable COPIES of the following:

a) the most recent Federal Income Tax form (s);

b) copies of pay stubs for the past two months if your employment circumstances have changed drastically since filing your last tax return and

c) documentation of any nontaxable income which does not appear on your Federal Income Tax form; or, if you are not required to file a Federal Income tax form, a letter from the Internal Revenue Service documenting that your income is less than a taxable amount, therefore your are not required to file. (The IRS can supply you with this letter by calling 800- 829-1040)

REQUIRED: Your answers to the next two questions are very important in our financial aid determination – please answer them thoughtfully and carefully!

Hidden

Please note any special circumstances that may help us evaluate your level of financial need (for example, medical expenses, single parent etc.):

Please share with us why taking or music instrument lessons is important to you/ your child:

Hidden

Please share with us why taking or music instrument lessons is important to you/ your child:

BSMA is committed to providing assistance to those students who might otherwise be unable to study at the school. Financial Assistance is offered to students based on need and commitment to their studies. Limitations in the amount of aid available may mean that not every student with a demonstrated need can be helped. There are no 100% awards given to any student and all students must pay the yearly registration fee. All applications received by the stated deadlines will be considered equally and the school will assist as many students as possible. All information submitted by students will be kept in strict confidence.

Students are expected to attend all lessons and classes and to practice daily to insure their satisfactory progress. Students are expected to participate regularly in student recitals and to attend at least one guest artist program at BSMA during the year. All lessons must be paid for whether taken or missed. Students will be charged the full rate for lessons missed which are not excused in advance by the teacher or the Executive Director. Two consecutive unexcused absences may be cause for withdrawal of the scholarship for the remainder of the school year. Families receiving assistance may be asked to volunteer their time at the Broadway School as the need arises.

The Broadway School of Music & the Arts does not discriminate on the basis of gender, race, color, nationality or ethnicity, origin or religion in any of its admissions or educational policies administered by the school.

I declare that the above information is correct and complete, and I understand that financial aid may be withdrawn from any student who does not maintain a record of cooperation, endeavor and achievement satisfactory to the Broadway School of Music & the Arts. I understand that: a) financial aid is awarded only for a period of one year; b) the award will appear as a credit on the student’s account and be proportionately distributed over one year provided the student continues to be enrolled and their account and attendance are in good standing; and c) I must request renewal on a yearly basis by filling out a new financial aid form.

Signature

Date

It is important that all questions on this form be answered as completely as possible in order to make proper financial aid determinations. Please call (216) 641- 0630 if you have any questions or need help in completing this form.

FOR OFFICE USE ONLY

DATE RECEIVED

ACTION

STAFF INTIALS

Date:

Notes: