Camp Financial Aid Application

INSTRUCTIONS

STEP 1: READ THE FINANCIAL AID INSTRUCTIONS AT BOTTOM OF THIS APPLICATION

STEP 2: COMPLETE THE ENTIRE APPLICATION AND SUBMIT IT WITH PROOF OF INCOME 

The following information MUST be completed for all applicants. 

(One application per student. )

Include verification of income from all sources (pay stub, tax return, proof of assistance, etc.) with this application.  Email verification to anna@musicallyminded.com 

INCOMPLETE APPLICATIONS WILL NOT BE REVIEWED.  PROOF OF INCOME IS REQUIRED.

Student is applying for financial assistance for: One selection per application. *

Camp

Class

Choir or Band

Student Name *

First and Last Name

Is Student an Adult *

YES

NO

Student Birthday *

Has the student received financial assistance from Musically Minded Academy before? *

YES

NO

Student Address *

Student Address

City

State/Province

Zip/Postal

Country

Parent or Guardian Name *

First and Last Name

Parent or Guardian Address (If different From student)

City

State/Province

Zip/Postal

Country

Parent or Guardian Phone (Student Phone if an adult) *

Parent or Guardian (Student if an adult) Email Address

Parent or Guardian Employment (Student if Adult) *

Employed

Self-Employed

Unemployed

Retired

Name of Employer *

Student lives with: *

Mother only

Father only

Both parents

Guardian

Number of children living at home *

Ages of Children Living at Home *

0-5

5-17

Over 17

Number of adults dependent on family income *

Gross monthly family income *

Annual household income level: *

Program Name Requiring Financial Aid (Write name of Program exactly as listed online) *

If applying for Camp Assistance What is Name of Camp? *

Camp Session *

Session 1

Session 2

Session 3

Session 4

Start Date of Program *

End Date of Program *

What is Cost of Program (DO NOT ADD OTHER FEES) ? *

Amount student can pay *

Amount requested (REQUIRED) *

Please indicate any special circumstances that relate to this request:

STEP 3: FUNDING RELEASE AND SIGNATURE

I certify that all of the information on this application and the supporting documents are true and complete. CAMP RELEASE: The Camper Program provides funding for a portion of our
camperships. In consideration of this campership application for sponsorship, I agree to the following conditions: (1) to allow my child to attend camp; (2) to contribute the amount of money
specified for my child to attend camp; (3) to allow my child to receive such medical treatment as may be considered necessary; and (4) MMA shall not be responsible for any disease,
injury or death to my child while traveling to, from or while attending camp.

Parent/Guardian Signature (REQUIRED) *

Signature Date *

STEP4: RETURNCOMPLETEDAPPLICATION

(DO NOT SUBMIT WITHOUT PROOF OF INCOME)
For questions, call 510 601 5700

NOTE: INCOMPLETE APPLICATIONS WILL NOT BE REVIEWED AND PROGRAM SPACE WILL NOT BE HELD.
PLEASE ALLOW UP TO 4 WEEKS FOR APPLICATION PROCESSING.

ALL INFORMATION ON THIS APPLICATION IS TREATED CONFIDENTIALLY AND SHREDDED AFTER USE

Financial Aid Instructions

To apply for financial aid:

1.  Select which aid you’re requesting on the financial aid form, being sure to fill out the entire application (One selection per application). Please do not add other selections to form.
2. The applicant must pay at least the deposit (if applicable). Should the financial aid amount requested not be fully granted and applicant chooses to cancel their registration, a refund of the deposit will be allowed.
3. Financial aid is based on need, and this must be clearly demonstrated on the form. MMA takes into account income level, family size, and a detailed explanation of circumstances when granting financial aid.
4. Documentation that verifies income level MUST be provided with the form as following:
    o (if employed, please provide copy of check stub or W2 or 1040 tax return)
    o (if unemployed, please provide copy of unemployment check or stub)
    o (if self-employed, please provide a statement of income for your business, Independent Contractor Agreement or tax document)
    o (if on leave, recently laid off or quit job please provide copy of most recent check or stub)
    o (if you just started employment, please provide copy of most recent check or stub)
    o (if receiving money from MediCal State Benefits, Disability or AFDC please provide copy as proof)
    o (if foster parent or guardian please provide proof of state coverage for student income only) 

Financial aid applications without proof of income will not be processed.

5. Financial aid funds are supplementary. Musically Minded Academy expects each family to pay as much as it can toward the cost of the student’s experience.
6. Financial aid funds are based on financial need and/or special circumstances. Based on what level a family qualifies for, aid can range from 20% 
    up to 80%..
7.  Applicants may be eligible for financial aid up to twice a year if the second experience is significantly different from the first.
8.  Fill out one application per student.
9.  Incomplete forms or those missing proof of income will not be reviewed.
10.  Please allow up to 4 weeks for application processing.

Musically Minded makes every effort to provide financial support so that no student is denied participation in a MMA experience due to lack of funds, however financial aid funds are limited.

Questions/Comments to: Anna Orias; email – anna@musicallyminded.com

Providing your email is the most efficient and cost effective way for us to notify you of the outcome