Youth Scholarship Application Form

Youth Scholarship Application

Have you EVER applied for this scholarship before?

Yes

Which year(s) did you previously apply?

Have you EVER received this scholarship before?

Yes

Are you under 18 years of age?

Yes

You will need to have a parent/guardian provide their details on this form, as well as indicate their knowledge and permission for you to apply for this scholarship. Your parent/guardian may also be contacted to verify any information provided on this application, and/or receive notices about its status.

Personal Details

First Name

Last Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Date of Birth

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Email

Your Application

The following questions relate to your application for this scholarship. Please answer all questions to the best of your ability.

Have you had any prior experience with Tai Chi or Qigong?

Yes

Please describe your prior experience in your own words

Why do you want to learn Tai Chi?

Are you willing to complete a full year (4 Terms - 40 weeks) of classes?

Yes

Where would you like to attend classes?

Which term would you like to commence in?

Demographic Information

This section helps us understand the demographics or our applicants, and is completely voluntary (you may choose to answer or not answer whichever questions you want). Your responses will not affect the outcome of your application. Please consider answering any/all questions as it helps us understand the sociocultural background of our applicants.

Your racial/ethnic identity

Your gender indentity

Do you have any sort of partial/full disability/handicap?

Yes

I'm unsure

Prefer not to say

Are you currently enrolled in some form of education?

Yes

I'm unsure

Prefer not to say

What type of schooling are you enrolled in?

Are you currently working for payment (full/part time, casual, temporary; for salary or wages)?

Yes

I'm unsure

Prefer not to say

Acknowledgement and Consent

Note: if you are under 18 years of age you will also need to have your parent/guardian complete this section.

By checking this box, I confirm my desire to apply for the Wisconsin Tai Chi Academy's Youth Scholarship Program, and confirm that I,

* have read the criteria for the scholarship;
* am eligible to apply for the scholarship;
* have answered all the required questions truthfully and to the best of my ability; and
* have, where I am under the age of 18 years, have informed my parent/guardian of my intent to apply for this scholarship, and obtained their consent to do so.

Please type your full name as an electronic record of your intent to submit this application.

By checking this box, I confirm that my child (the applicant) has informed me of their intent to apply for the Wisconsin Tai Chi Academy's Youth Scholarship program, that I am aware of the conditions and requirements of the program, and give my permission for my child's application to be submitted for consideration.

I further acknowledge and consent to the details I provided to be used to contact me to ask questions about this application, or confirm its status.

Please type your full name as an electronic record of your consent for your child's application to be submitted and considered.