Youth Scholarship Application Before completing this form, please read the overview and terms here. Order Number Name * Date of Birth * day/month/year Email * Phone Cell Address Address Line 2 City * Province * Postal Code * Musical experience/achievements/background: * 200-400 Words Description of Proposed Activity/ies: * 200-400 words Date/s of Activity/ies: * What impact would receiving this scholarship have on your musical development? * max. 200 words Estimated Expenses (totalling no more than $500): Please enter only the numeric value (without a $ sign) for the amounts below. Expense 1 Description Expense 2 Description Expense 3 Description Expense 4 Description Total Expenses: Expense 1 Amount Expense 2 Amount Expense 3 Amount Expense 4 Amount Total Expenses $ Confirmation By checking this button, I confirm that I am the applicant named above and that I agree to the terms of the scholarship program. The following is required for applicants under the age of 17 on the day they submit their application. Parental Consent By checking this button, I confirm that I am the parent/legal guardian of this applicant and give consent to Elektra Women's Choir to use their name and photograph in promotional material concerning the scholarship and other choir activities. Scholarship recipients give Elektra Women’s Choir their consent to use their name and photograph in promotion concerning the scholarship and other choir activities.