FHSR Short Historical Documentary

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A Sound Investment in Our Children

FHSR is a qualified 501(C)(3) tax exempt organization. Tax ID number 36-6082810.

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MTME SCHOLARSHIP APPLICATION

Candidate Information

Name *

First

Last

Birthday//

How did you hear about the scholarship program?

FHSR event
Service provider
Website
Social media

Name of referring institution/school

Parent/Guardian Information *

First

Last

Phone *

Email *

Relationship to applicant *

Residence

Address Line 1

Address Line 2

City

State

Zip Code

Information regarding the applicant

Hearing loss level

Device used (if any)

Music class location preference

Schedule preference

Please tell us anything else you'd like to share