All information will be held in strict confidence

Student's Name   ________________________________________________
Parent(s) Name(s) ________________________________________________
Address____________________________________
Apt. No.______________
City__________________State___Zip________
Home Tel. (____)___________
Work Tel (____)__________Fax (____)___________
E-mail_________________

Parents, please answer the following questions:

Are you receiving any other financial aid for your child's musical education or related travel?

yes    no

If yes, please list sources and amounts:________________________________

If you live more than 30 miles outside of the Greater Cincinnati area, please list your estimated annual travel expenses:

Car travel:______ 
Air travel:______  Lodging:______  Food:_______

Please list and explain any additional relevant circumstances on an additional sheet.

  Adjusted Gross Income Estimated Real Estate Values Savings Other Investments
Father
Mother

  Encumbrances on Real Estate Other Obligations Loans Other Expenses
Father
Mother

Father's Signature  __________________________  Date___________
Mother's Signature __________________________  Date___________

For reasons of confidentiality, PLEASE DO NOT FAX THIS FORM

MAIL TO:
STARLING PREPARATORY STRING PROJECT
ATT. SCHOLARSHIP COMMITTEE
COLLEGE-CONSERVATORY OF MUSIC
UNIVERSITY OF CINCINNATI
P.O. BOX 210003
CINCINNATI, OH 45221-0003

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