Betty Cline Scholarship Application

The Hickory Music Factory has an annual $45 student registration fee and $25 for each additional sibling. If you are not currently registered, this will need to be paid if accepted for a scholarship. Please keep in mind that immediate family members may not be used as references. Appropriate references will include teachers, scout leaders, church leaders, coaches, etc.

Applicant's Name

First Name

Last Name

Age

School

Grade

Guardian's Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

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Place of employment

Ethnicity

Caseworker / House Manager

First Name

Last Name

Phone

(###)

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Please select what you are applying for

Lessons

Programs

Are you currently taking lessons? If so, please state where you take lessons, who your teacher is, and what instrument you are currently learning.

Have you ever received an HMF scholarship? If so, when?

Are you currently on an HMF scholarship?

Yes

In a minimum of three sentences, describe your goals and interests, and how this scholarship will help you (applicant) achieve them.

List styles of music and artists/bands you (applicant) are interested in.

List instrument(s) you (applicant) play or are interested in learning.

The Hickory Music Factory offers a limited number of scholarships to students each year. Applicants are assessed through written or online applications by the HMF Board of Directors. Funding for scholarships are made possible through private donations that help provide lessons and programs to youth in the community who may not have the means to do so. Students receiving funds are responsible for attending all activities and programs. They are also responsible for volunteering hours and helping work at HMF sponsored events when needed. Failure to comply with these terms of the scholarship will result in revocation of the scholarship.

Yes