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Capital Campaign
Zak Pullen Mural
Meet Our Team
Donate Now
Age Groups
Ages 4-7
Ages 8-18
Workshops
Calendar
Scholarships
Menu
Home
Support Us
Capital Campaign
Zak Pullen Mural
Meet Our Team
Donate Now
Age Groups
Ages 4-7
Ages 8-18
Workshops
Calendar
Scholarships
Student Name
*
Parent Name
*
Primary Email Address
*
Primary Mailing Address
*
Primary Phone Number
*
Name of Production or Camp Scholarship Will be Used for:
*
Household Size
*
2
3
4
5
6
7
8
9
10+
How many people live in your home?
Number of children under age 18 in your home:
*
1
2
3
4
5
6
7
8
9
10+
Is yours a single parent in the household?
*
Yes
No
Student Applicant Grade Level
*
Preschool
K-2nd
3rd-5th
Middle School
High School
Do you and/or your household qualify for Free and Reduced Lunch or other public assistance programs?*
*
Yes
No
Household Annual Income Level
*
Under 15K
$15 - 24,999$25 - 34,999
$35 - 44,999
$45 - 54,999
$55 - 64,999
$65 - 79,999
$80k+
(Include income from work, welfare, child support, alimony, pension, social security and disability, and any other sources)
How did you hear about the CCT Scholarship Program program?
*
While household income is a major factor, we recognize other circumstances affect families’ economic realities. Please write a 3-4 sentence statement clarifying your need for economic assistance for CCT Programs this season. You may also inform us of any additional barriers for your family, including transportation, language, and/or special needs.
*
