Scholorship

Applicant's Full Name

Partner's Name

Phone Number

Email Address

Mailing Address

Applicant (Caller) Dancing and Calling History:

1. How long have you been square dancing? (yrs):

2. How long have you been calling? (yrs)

3. Have you attended any other caller schools, clinics or CALLERLAB conventions prior to this application? (y or n)

(If yes to 3. above, please list those schools and or clinics previously attended and give the state(s) of attendance.)

Schools / CALLERLAB Conventions Attended / Date

Event 1 Name

Date 1

Event 2 Name

Date 2

Event 3 Name

Date 3

Event 4 Name

Date 4

Caller School / Convention Details:

4. If your goal is to attend a caller school, please answer the following questions:

Name of School

Date you will attend (mm/dd/yyyy)

How long is the School? (Days)

Name of school CALLERLAB Accredited Caller Coach

Does tuition fee include room & board? (y or n)

Cost of school: Tuition $___ + Room & Board $___ = Total Cost $___

5. If your goal is to attend the CALLERLAB convention, please answer the following questions:

Date you will attend: (mm/dd/yyyy)

Cost of school: Tuition $___ + Room & Board $___ = Total Cost $___

6. Do you intend on becoming a full time caller? (y or n)

7. Have you received any scholarship before? (y or n)

If you answered YES to the above question, from whom did you receive your award(s)?

Purpose for the Scholarship

This Scholarship Award shall be based on financial need, current calling experience and the stated intentions. Please answer the following to help us understand why you feel you qualify to receive the scholarship from the Lee Kopman Fund:

8. I need this scholarship because:

9. How do you intend to use your calling skills?:

Note: Applications must be submitted before the School / CALLERLAB Convention begins. If attendance is contingent on receiving a Scholarship, the Application should be submitted 30 days before the School / CALLERLAB Convention to allow the Fund Executive Directors time to consider.

APPLICATIONS RECEIVED AFTER THE SCHOOL WILL NOT BE CONSIDERED

Submit

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Lee Kopman
Square Dance Man

Lee Kopman Scholarship Fund Application Form for Callers