Music Therapy Financial Assistance Application

Name *

First

Last

Email *

All applicants need to submit the appropriate registration fee of $30/client or $60/family and the required session deposit. Applicants will be informed of their tuition balance, after the financial aid awards are determined. You can initiate this process, if you have not already done so, by submitting a session inquiry.

I have completed the inquiry or registration process
I need to complete the inquiry or registration process

I understand that receiving financial assistance requires the following commitment on the recipient's part:

Regular attendance at sessions. (Mandatory)

Applicants are asked to seriously consider and record on this form what they can reasonably afford to pay toward the cost of Music Therapy. The Music School does not offer full tuition need-based awards. Financial assistance is granted according to guidelines established by the Financial Aid Committee, which reviews all applications and makes awards. All applications are held in strict confidence.

Will the cost of your Music Therapy services be covered in part or in full by a third party?

Please submit proof of total household income by uploading a copy of your most recent Federal 1040 and Schedule A (& C if filed). If you need help contact Registrar at registrar@mcmusicschool.org.

Click or drag a file to this area to upload.

Please write a personal letter addressing how this award will benefit the applicant. Also include any additional information regarding need or extenuating circumstances that explain your request for assistance. *

Guardian / Adult Client Info *

First

Last

Address

Company Name and Job Title

Guardian 2

First

Last

Address

Company Name and Job Title

Guardian 1 Gross Yearly Income (current tax year)

Guardian 2 Gross Yearly Income (current tax year)

Client Gross Yearly Income (if adult)

Unemployment Income

Alimony Income

Child Support Income

Rental Income

Social Security Income

Investment Income

Other Income

Do you file a Schedule C?

If so, please include pages 1 & 2 with your Federal 1040.

TOTAL YEARLY GROSS INCOME *

Total number of people supported by this income: *

Name of client(s) for whom you are requesting financial assistance:

Are you a returning client? Is so, previous music therapist's name:

Have you received Financial Assistance from MCMS in the past?

Please list the session (including length), classes and ensembles for each member of the family who is included in this aid request. (i.e. Jane - 30 min Music Therapy Session)

Estimated Family Payment: (What can you contribute MONTHLY as a family? This question must be completed.) *

I declare that I have completed this form to the best of my knowledge. I believe it to be true, correct and complete. I understand that I have to submit my most recent Federal 1040 and Schedule A forms to complete this application. *

I agree

Guardian Signature *

Comment

Manchester Community Music School

Music Therapy Financial Assistance Application

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Changing lives through the power of learning, sharing and making music.

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