Nomination Form – Arizona Musicfest Scholarship for Summer Programs

Nominating Organization/Individual Information
Name of Person filling out this form*

First

Last
Organization:*
Position / Title*
Student Information
Student Name*

First

Middle

Last
Parent/Guardian Name*

First

Middle

Last
Contact Phone Number*
Contact Email*
Home Mailing Address*

Street Address

Address Line 2

City

State

ZIP Code
Current Grade (2023-2024)*
Instrument*
# of Years Playing Instrument*
Summer Program Information
Program Name*
Program Address*

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country
Program Website*
Program Dates (Planned Attendance)*
Total Out-of-Pocket Cost for Student*
Personal Statement
Please list any musical activities the student is currently participating in or has participated in.*
Why are you nominating this student?*
Acknowledgements
Attestation*
By checking this box and upon submission of this application I affirm that, to the best of my knowledge, the information provided on this application is accurate and factual.

Nominating Organization/Individual Information