Scholarship Application 2021 Please complete the following form in its entirety by August 28, 2021, for consideration for the 2021-2022 school year. Any questions may be directed to the School of Mareck Center for Dance at school@missouricontemporaryballet.org or 573-825-0095. Student's Name* First Last Gender* Male Female Date of Birth* Month Day Year Phone*Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Student's Email Parent's InformationParent/Guardian's Name* First Last Required for students under 18.Relationship to Student*FatherMotherGuardianParent's Cell/Work Phone*Parent's Email* Household Income for the year ending December 31, 2020*Under $15,000$15,001-$25,000$25,001-$35,000$35,001-$45,000$45,001 +Household Size* Household Type*Single ParentTwo ParentsGrandparent/RelativeFosterOtherAre there any unusual expenses or extraordinary circumstances that led you to apply for this scholarship?*Previous dance experience*Include name of organization, classes, number of yearsFor student: Why are you applying for and deserving of a scholarship at the Mareck Center for Dance?*For previous scholarship recipients: How did a previous scholarship award affect you and in what ways did you give back as an ambassador to the Mareck Center for Dance?Attach a copy of the 2020 federal income tax forms of the person who is responsible for tuition for the applicant*Accepted file types: pdf, Max. file size: 100 MB.For new applicants: attach one letter of recommendation from a non-family member (not required for applicants who have received a scholarship within the past year)Max. file size: 100 MB.