Pat & Sven Peterson Scholarship Application

For the Summer 2024 Scholarship, please submit this form and two reference letters by Friday, May 3, 2024. You must be a current member of Dance Alliance to apply for the scholarship.

Name: *


First	Last

Address: *

Street AddressStreet Address Line 2CityState / Province / RegionPostal / Zip Code

Are you a current member of Dance Alliance?: *

Yes

Home Phone:

-
Area Code	Phone Number

Cell Phone:

-
Area Code	Phone Number

E-mail: *

School Currently Attending (Academic) and grade or year. *

School Currently Attending (Dance) *

Please provide two references and their telephone numbers (One should be your dance teacher; the other may be an academic teacher, employes, coach, etc.): *

Plans for study at: *

Contact Person’s Name: *


First	Last

Email or Web Site: *

School Location: *

CityState / Province / Region

Contact Person's Phone: *

-
Area Code	Phone Number

Dates of Program: *

Type of classes offered and by whom: *

Total Cost of Summer Study: *

Itemized expenses for tuition, room, board, etc: *

ESSAY: Please explain in your own words how this scholarship will help you personally (IE: technique, financial, experience) and how your attending this program will help your community. (Either enter or paste text here or upload a word document below).

Upload a File: