The Mashburn Scholarship Foundation
Scholarship Application
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Name: Social Security Number: Date of Birth: Permanent Address: Street: City: State: Telephone number: Email address: 5 Parent's name: Address: Street: City: State: 6 Siblings' Names and Ages: 7 Occupation and employer of: Father: Mother: 8 List major family financial obligations:
Zip Code: Cell Phone:
Zip Code:
9 Parents' combined adjusted gross income from last year's tax return: 10 Work Experience: Are you presently employed: Yes: No: If Yes, where? How many hours per week? Do you plan to work while attending college? Yes: No: Anticipated Weekly Earnings: 11 In addition to support from parents and/or earnings from part-time work, what do you expect your financial need to be for each year in college? 12 Are you receiving any other scholarship assistance? Yes: No:
If Yes, please explain: 13 What College or University do you plan to attend? 14 Date of Graduation, and from what High School? 15 Cumulative Grade Point Average to date:
16 Have you earned any College credits? If so, where? Cumulative College Grade Point Average: 17 List school activities in which you have participated:
18 If there are any special circumstances of which you feel the committee should consider in evaluation your application, please provide a brief explanation on the back of this application. 19 Will you be available to perform in the Barbara Mashburn Scholarship Foundation Benefit Performance on the first Sunday in March? Yes No What type of music do you like to perform?
20 Other than minor traffic violations, have you ever been convicted of, or pleaded guilty to, a crime? Yes No 21 If the answer to the previous question is "yes", give all details, including dates:
22 Other than minor traffic violations, are there any pending criminal charges against you? Yes No 23 If the answer to the previous question is "yes, Give all details including the status of the charges:
24 Do you have any objection to being tested for drugs or alcohol use with the understanding that the results would remain confidential? Yes No 25 Do you consider yourself to be of good moral character and a good role model? Please give examples:
26 Describe in 100 words or less how you see yourself in the future music world - education, production, performance, other:
27 Give the name, address, and telephone number of three references. Please limit teacher references to two. Have these references write their recommendations and send them to the Barbara Mashburn Scholarship Foundation at the address listed below. Name Name Name Address Address Address Phone Phone Phone
28 SAT Score 29 ACT Score 30 I agree to be interviewed and auditioned by the Barbara Mashburn Scholarship Foundation Committee and that the information in this application is true and correct to the best of my knowledge. Applicant's Signature Parent's Signature Date Date
Please return application along with a copy of your transcript and your parents' most current tax return to: The Mashburn Scholarship Foundation 1765 N College Avenue, Suite 8 & 9 Fayetteville, AR 72703 Application Deadline is _____________________. You must have all information in before this deadline to be considered for the Scholarship. Auditions will be held _________________________
Please note that this is a scholarship for Singers who intend to major in Vocal Performance, Music Education, or Musical Theater. Why do you want to be a part of the Barbara Mashburn Scholarship Foundation?
