KIDS FIRST! FILM CRITICS BOOT CAMP
2015 Scholarship Application Form
A limited number of full and partial scholarships are available in select cities. See below for details. The student and one legal guardian must complete the application.
· Please type or print in ink. Do not handwrite.
· Deadline: Return with all support documentation no later than 45 days prior to the camp start date in the city for which you are applying.
I am applying for a scholarship for the KIDS FIRST! Film Critics Boot Camp taking place at (check one below). Please note that, in general, scholarships are only available for local students in each city.
□ Santa Fe Community College, Santa Fe, NM (2 partial scholarships of $100 each)
□ B-47 Studios, Seattle, WA (2 partial scholarships of $100 each)
□ Martha's Vineyard Film Center, Vineyard Haven, MA (3 full scholarships for local residents only)
□ Hispanic Information and Technology, Brooklyn, NY (4 full scholarships for local participations only)
□ Discovery Communications, Silver Spring, MD (3 partial scholarships for local participants only)
Scholarship results will be announced approximately three weeks prior to the camp start date.
A. Student information
Name_____________________________________________
Email Address______________________________________
Home Phone Cell Phone_________
Birth Date Gender __________________
Are you a U.S. citizen? _______________________________
B. Parent Information
Mother's Name______________________________________
Email Address______________________________________
Home Phone Work Phone________
Cell Phone_________________________________________
Street_________________________________________ __
City State Zip Code__ ____ ___
Father's Name______________________________________
Email Address______________________________________
Home Phone Work Phone________
Cell Phone_________________________________________
Street_________________________________________ __
City State Zip Code__ ____ ___
C. Total Family Income (check one)
□ Under $30,000/yr.
□ $30,000 - 60,000/yr.
□ $60,000 - $100,000/yr
□ Over $100,000/yr.
D. Number of family members living in household. ____________________
E. Why you would like to attend the Film Critics Boot Camp (100 words).
F. Reason for Scholarship Request (100 words).
Parent name (print) _____________________Signature
Date
Student name (print) ____________________Signature _________________________
Date
Fax or email completed Scholarship Request to
Fax: 505-986-8477
Email:
KIDS FIRST! Film Critics Boot Camp is a project of the nonprofit, 501-c-3 organization,
Coalition for Quality Children’s Media
112 W. San Francisco St. Suite 305A Santa Fe, NM 87501
505-989-8076 www.kidsfirst.org