WORCESTER COUNTY ARTS COUNCIL, INC.
6 Jefferson Street
Berlin, Maryland 21811
410-641-0809
ARTS SCHOLARSHIP APPLICATION
APPLICATION DEADLINE: MARCH 15, 2016
NOTE: All requested information must be completed. If the requested
information does not apply to you, please indicate by writing N/A.
Date: ______________________
(1.1)Name: _______________________________________ (1.2) SS #: ___________________
(1.3)Address: __________________________________________________________________
(1.4)Telephone No.: ______________ (1.5) Age: _____ (1.6) Email_______________________
(1.7)Parent's Name: ___________________________________ (1.8)Tel. No.: ______________
(1.9)Parent's Address: ___________________________________________________________
(1.10)Area of Arts Study (dance, drama/theater, media arts, music, visual arts, writing):
______________________________________________________________________________
(1.11)Specific area of interest (i.e. performing arts, visual, or writing genre):
______________________________________________________________________________
______________________________________________________________________________
(1.12)Do you intend to pursue a career in the Arts? ___________________________________
(1.13)Name and address of High School or College you are currently attending:
______________________________________________________________________________
______________________________________________________________________________
(1.14)Expected Graduation Date: __________________________________________________
Names of teachers with whom you study (indicate whether private study or through school):
(1.15)Name: _______________________________ Years of Study: ______________________
(1.16)Name: _______________________________ Years of Study: ______________________
(1.17)Name: _______________________________ Years of Study: ______________________
(Arts Scholarship Application page 2)
(2.1)List the school and extra curricular activities in which you are involved (both arts and nonarts):
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
(2.2)List any school honors or other merit awards (other than financial) you have received:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
(2.3)Have you been accepted to and participated in any special summer arts programs?
Yes ______ No _______
If yes, please list the programs (i.e. Maryland Gifted and Talented Summer Program, etc.):
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
(2.4)Have you participated in the Maryland Distinguished Scholar Program? Yes ___ No _____
If you have participated in the Maryland Distinguished Scholar Program, list your area(s) of
concentration and indicate the results of your participation:
______________________________________________________________________________
______________________________________________________________________________
(2.5)If currently in high school, to what colleges, universities, or specialized schools have you
applied?
______________________________________________________________________________
______________________________________________________________________________
(Arts Scholarship Application page 3)
(3.1)Where have you been accepted?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
FOR APPLICANTS CURRENTLY IN COLLEGE - complete 3.2 – 3.5
(3.2)If currently attending college, university, or other specialized school, what is your major and
degree program?
______________________________________________________________________________
(3.3)Have you attended other colleges and where?
______________________________________________________________________________
______________________________________________________________________________
(3.4)Years of study: _____________________________________________________________
(3.5)Reasons for leaving: _________________________________________________________
ALL APPLICANTS MUST COMPLETE 3.6
(3.6)Use this space to tell us why you have chosen your arts field and its
importance to you:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
(Arts Scholarship Application page 4)
(4.1)Please indicate in what format your work is being submitted:
 DVD
 CD
 Other (specify) _________________________________
(4.2)You must include the following required information for each of the works you have chosen.
Each work must (a) be numbered and include a title, (b) name the style or media used, and
(c) Describe how it best represents your artistic abilities, skills, and goals.
For this section, please choose one of the following…
I will list the above required information on this form _______
The above required information is on my CD/DVD _________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
CHECKLIST - Be sure to include
1. Completed Application (not handwritten)
2. Two (2) sealed letters of recommendation from teachers, artists, or professionals related
to the arts and familiar with your artistic work.
3. Copy of your academic transcript
4. CD or DVD of your work.