Today's Date*:

Full Name of Student*:

Parent/Guardian Name(s) (if under 18):

Phone*:

Email*:

Mailing Address*:

City*:

State*: ALAKAZARCACOCTDCDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY

Zip*:

Please indicate what class the scholarship would be applied to:
Class Title*:
Class Date*:

Has the student received a scholarship from the Emerson before?* YesNo

If yes, for what class and when?
Class Title:
Class Date:

Please explain why the student is interested in this class and why a scholarship would benefit.*

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Scholarship applications are reviewed monthly, please do not register before hearing back from us regarding your scholarship. We are unable to retroactively apply scholarships.