Avery Mathieu Scholarship Application - Art Association of Jackson Hole

The Art Association is dedicated to encouraging a vital, creative community by providing everyone with exposure to, education in, and enjoyment of a wide variety of art.

Parent/Guardian Name(Required)

First Last

Relationship to Student(Required)

Mailing Address(Required)

Address City State / Province / Region ZIP / Postal Code

Cell Phone(Required)

Home Phone

Parent / Guardian Employer Name(Required)

Employer Phone(Required)

Student Name(Required)

First Last

If scholarship is awarded, what class would you like to attend?

Class Choice 1(Required)

Class Choice 2(Required)

Scholarship Amount Requested(Required)

50% of class maximum

Please provide a brief description of your financial situation/need for assistance.(Required)

Please include a brief explanation of why taking this class is important to you!

Number of Adults in Household(Required)

Number of Children (under 18) in Household(Required)

To maintain the integrity of Financial Assistance you may be asked to submit a copy of your recently filed U.S.Federal Income Tax Return (Form 1040) – this tax return would be used for evaluation purposes only and would remain strictly confidential.

Signature(Required)