Kathryn T. Greathouse Legacy Scholarship - Application

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Student's Full Name *

Artistic Discipline *

Date of Birth *

YYYY

Academic School Enrolled *

Class of *

Address *

City

State

Zip

Email *

Phone Number *

Parent/Guardian's Name(s) *

Parent Email *

Parent Phone Number *

Artistic Training

Teacher's Name *

Teacher Email *

Teacher Phone Number *

Description of Artistic Training *

Description of Proposed Use of Funds *

Attachments:

1. A written recommendation by the teacher listed in this application.

2. Proof of age (i.e. Copy of Driver's License, Birth Certificate, or Passport)

File Upload *