Scholarship application form

SCHOLARSHIP APPLICATION FORM
Dear Scholarship Applicant:
Thank you for your interest in WHY’s 200 hour Teacher Training. Enclosed is the application form for our scholarship program. This letter will help determine whether you are eligible for a scholarship. It also contains important information regarding application deadlines, so please read it thoroughly.
Scholarships are made possible through the generosity of the West Hartford Yoga community.
Determining your eligibility for a scholarship
Financial need is assessed on the basis of your annual household income. The table below shows you if your income level qualifies you to apply for a scholarship.
# of people in household Max gross household income

1. 
   $25,500
   
2. 
   $31,500
   
3. 
   $37,500
   
4. 
   $43,500
   

Scholarship Amounts
Scholarships typically cover from 10% to 20% of total program costs.
Application Deadlines
Applications must be received no later than December 15, 2015.
Please e-mail completed applications to [e-mail] or
mail to:

WHY Teacher Training Scholarship Program

West Hartford Yoga

23 Brook Street

West Hartford, CT 06110
If you have any questions, please contact Jennifer Leavitt at 860-953-9642.
Personal Information

Last Name First Name

Address

City State Zip

Home Phone Number Work Phone Number Cell Phone Number

E-mail Address

Occupation Employer

Scholarship Amount Requested
$
Annual Household Income (please check one box)

	$0 to $15,000		$15,001 to $20,000
	$20,001 to $25,000		$25,001 to $30,000
	$30,001 to $35,000		Greater than $35,000

Other Financial Considerations



Personal Essay
In awarding scholarships we take into account a variety of factors in addition to financial need. Please take a moment to describe why you want to attend WHY’s Teacher Training and why we should consider you for a scholarship. (Please attach addition sheets if necessary.)

I certify that all the information I have provided is complete and accurate and that I have given a full disclosure of my financial status. I understand that all the information in this application will be kept strictly confidential and only used to determine my eligibility for a scholarship. I further understand that if awarded a scholarship I may also be required to perform some work study for the as part of the scholarship program.

Signature Date

West Hartford Yoga, L.L.C. Barbara Ruzansky, Director

23 Brook Street (860) 953 YOGA (9642)

West Hartford, CT 06110 www.westhartfordyoga.com