Scholarship Application Form

To apply for a scholarship please fill out this form online, print it, and return it with your registration form to Luna Kids Dance, 2138 Cedar Street, Berkeley, CA 94709.  This process must be started well in advance of the first day of classes.  Call our office for more information 510-644-3629

Student's Name:
Age: Birthdate:
Parent/Guardian Name(s):
Phone No:
Address:

Name of LKD class enrolling in:
Location:
Day & Time:

The information you provide for us below will help determine how to allocate our scholarships. Please answer the following questions:

1. I would like a scholarship for the following reason (use additional page if necessary).
   


2. Please check box:
   I understand my child must attend ALL classes in a session in order to be eligible for scholarship.
   


3. I can contribute this amount to my child's dance class:
   10%
   25%
   50%
   70%
   Other __________
   I cannot contribute anything this semester.
   

Thank you for your application. A representative of Luna Kids Dance will be in contact with you prior to the start date of classes.