COMMUNITY FOUNDATION for MUSKEGON COUNTY

Alfonso Loera Music Scholarship Application

Print using black ink or type. All blanks must be filled out for application to be considered.

1. Please circle the scholarship type you are applying for: Type I Type 2

2. Social Security Number:_____________________________________________________

3. Last Name:_________________________ First name:_____________________ Middle Initial:_______

4. Street Address:________________________ City:____________________ State:_____ Zip:__________

5. Birthdate:______________ Telephone:____________________ E-mail address:_____________________

6. Are you a Muskegon County resident? Yes No

7. School or College currently or last attended:_______________________________________________

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Street:___________________________ City:_______________________ State:_________ Zip:_______

Graduation Date:_________________________ School Telephone: _______________________________

8. School or College attending next fall:______________________________________________________

Street:___________________________ City:_______________________ State:_________ Zip:_______

Graduation Date:_________________________ School Telephone: _______________________________

9. What area of music (i.e., instrument, vocal, etc.,) do you plan on pursuing: ______________

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10. Please describe any previous experience in the field of music, including, ensembles, awards, lessons, etc. (Please indicate dates where appropriate).

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