Parent/Guardian Information

First Name *

Last Name *

MI

Address 1 *

Address 2

Phone

Email Address

City *

State *

Zip Code *

Marital Status *

Residence Status *

US Citizen

US Permanent Resident

International Student

Income

Employer *

Position *

Salary *

Work phone *

Additional Income

Student Name Applying

Please list all classes planning on taking *

Terms & Conditions I certify that the information submitted in this application is complete and correct to the best of my knowledge and I will notify LA Beatz Dance, LLC of any changes in the above information. LA Beatz Dance, LLC has the right to withdraw or change scholarship amount due to parent(s)/guardian(s) employment or status change. All information related to this application will be reviewed only by the Executive Director and Co-Director and will be kept strictly confidential. Upon review, notification will be sent via email indicating approval or denial of your request, including the amount of scholarship granted. Due to the generous financial expenditure made through our scholarship program, we require that all scholarship recipients dance exclusively with LABD during the academic year . Scholarships are for tuition only and all other fees and costumes must be paid for according to LABD guidelines. I agree to the terms above and will submit my most recent 1040 tax return form.