String Scholarship Agreement Form

Choose your instructor and sign the agreement for your Scholarship with this form.

Name of String Scholarship Winner(Required)

First Last

Email of Parent of Winner(Required)

Cell Phone Number of Parent or High School Student(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Prefered form of contact

Phone Call

Text

Mail

If you are playing the violin - VIOLIN Teacher Choice: The La Crosse Symphony Orchestra will provide up to $150 per semester for two semesters for your child to study with an LSO musician. You are required to pay the instructor any additional lesson charges. Please indicate who you choose for your instructor:

If you are playing the cello - CELLO Teacher Choice: The La Crosse Symphony Orchestra will provide up to $150 per semester for two semesters for your child to study with an LSO musician. You are required to pay the instructor any additional lesson charges. Please indicate who you choose for your instructor:

If you play the viola - VIOLA Teacher Choice: The La Crosse Symphony Orchestra will provide up to $150 per semester for two semesters for your child to study with an LSO musician. You are required to pay the instructor any additional lesson charges. Please indicate who you choose for your instructor:

If you play the bass - BASS Teacher Choice: The La Crosse Symphony Orchestra will provide up to $150 per semester for two semesters for your child to study with an LSO musician. You are required to pay the instructor any additional lesson charges. Please indicate who you choose for your instructor:

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String Scholarship Agreement Form

String Scholarship Agreement Form

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