Ashley Foundation Student Application Process

Name ____________________________________________________________________
Age ________
Address __________________________________________________________________
Phone Number (Include area code)____________  e-Mail Address ____________________
Parents Name ______________________________________________________________
Parents Address ____________________________________________________________
Parents e-Mail ______________________________________________________________
School Name _______________________________________________________________
School Address _____________________________________________________________
School Grade __________ Instrument ___________________________________________
How Long You Have Played ________  Do You Study Privately __________
School Director and/or Private Teachers Name

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School Director and/or Private Teachers Phone Number (Include area code)

__________________________________________________________________

List of Musical Groups You Are or Have Been a Part of and Length of Participation in Each Group:
1 ________________________________________________________________
2 ________________________________________________________________
3 ________________________________________________________________
4 ________________________________________________________________

Write Two Short Paragraphs on Why You Need Scholarship Assistance and What It Would Be Used For:
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________________________________________________________________________
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Two Letters of Reference From Persons of Authority, Such as a Teacher

Attach a Brochure From The Workshop/Clinic/Camp You Wish to Attend (if applicable)


Applicant Signature ____________________________________________________
Date _________________

Parent or Guardian Signature (if applicable)
Sign ________________________________________________________________
Date _________________

Submit Application To:

The Ashley Willwerth Foundation
P. O. Box 1685
Saint Augustine, Florida  32085
(904) 823-9012