Band of Gold
Application for Service Scholarship Form

 

First Name

Last Name

Social Security Number

Name of Parent or Guardian

Date of Application

Address (Line 1)

Address (Line 2)

City

State

Zipcode

Phone

( ) - -

Email

High School
Intended Major

 

Intended campus:

 Jackson County Campus
 Jefferson Davis Campus
 Perkinston Campus

Note - All students attending JC or JD are responsible for their own transportation to the Perkinston Campus.
   

Instrument(s) - Baritones specify treble or bass clef. Percussion, specify which instrument in order of your playing ability.

   

Flag Rifle Perkette Baton Other

   

To receive and maintain a Service Scholarship, the undersigned student hereby aggress to the following –

Read the following information carefully before you sign this application.

1. To attend all preparatory rehearsals and sectionals.

2. To attend and perform all scheduled public performance activities.

3. To schedule classes, work and other activities so as not to conflict with the scholarship activities.

4. To work alone when necessary to improve talents, techniques and routines in a completely acceptable manner for performance before the public.

5. To care for and maintain all school-owned equipment (including uniform) checked out by me, and to return same in proper condition when requested to do so.

(NOTE: Failure to return any equipment by the end of the semester when requested will (1) result in the student’s grade reports being held; (2) prevent transcripts and other notices of satisfactory withdrawal from being sent to other institutions; and (3) prevent the student from registering at MGCCC.)

6. To work in assigned area during the period of the scholarship.

7. To abide by school and band policies.

8. To pay all deposits and fees prior to band camp.

I have read and understand the above scholarship requirements and will abide by them in order to receive and maintain a scholarship.

Signature


(By entering your name in this box, you agree that this substitute will serve as your signature)

 


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