Request an Instrument - Step Up - Ted Brown Music Outreach

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Request an Instrument
- Request an Instrument - Beginner
- Request an Instrument - Step Up
Scholarships
- Summer Camp Scholarships
- Music Therapy Scholarship
Contact
Music Therapy

Request an Instrument - Step Up

Who is eligible: Any student between the ages of 14 and 18 and can demonstrate financial need.

Instrument Request Form - Step Up

* Indicates required field

School Name *

Instrument Requested *

(If Other Please Specify) *

Parent/Guardian Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Contact Email *

Phone Number *

Please describe your financial need. Include household income and family size *

This information provided is true and factual (Student - type your name) *

Student's Name *

First

Last

Age *

M / F *

Male Female Other gender identification Prefer not to answer

Student Is: *

American Indian/Alaska Native Asian Black/African American Native Hawaiian/Pacific Islander White Prefer not to answer

Ethnicity: *

Hispanic/Latino Non-Hispanic/Latino Prefer not to answer

Please describe your musical goals and include any awards and honors (Limit to 1 page) *

Max file size: 20MB

Please attach a letter from your teacher recommending you for this scholarship (limit to 1 page) *

Max file size: 20MB

How did you hear about Ted Brown Music Outreach *

This information provided is true and factual (parent - type your name) *

Submit

Downloadable form

Form in Spanish

outreach_request_instrument-step_up.docx
File Size:	41 kb
File Type:	docx

outreach_request_instrument-step_up_spanish.docx
File Size:	41 kb
File Type:	docx

outreach_request_instrument-step_up.pdf
File Size:	112 kb
File Type:	pdf

outreach_request_instrument-step_up_spanish.pdf
File Size:	79 kb
File Type:	pdf

Home
About
Programs
Donate
Events
Request an Instrument
- Request an Instrument - Beginner
- Request an Instrument - Step Up
Scholarships
- Summer Camp Scholarships
- Music Therapy Scholarship
Contact
Music Therapy