Student Application Form

Arthur Chatfield Music Scholarship

Instructions: Please print clearly or type. Return completed form to:

Arthur Chatfield Music Scholarship Committee
c/o Music Department Chair
Community College of Rhode Island
400 East Avenue
Warwick, RI 02886-1807

Application Deadline April 1.

Name________________________________________ Student I.D. #_____________________

Address_________________________________ City________________ State____ Zip_______

Telephone__________________________________ email_______________________________

1. Are you enrolled in the Associate of Fine Arts-Music Degree Program? Yes__ No__

2. Have you completed a minimum of nine (9) credits in the Associate of Fine Arts Degree Program? Yes__ No__

3. If you have completed more than nine (9) credits, please list number of credits completed. ____


4. Are you pre-registered for a minimum of six (6) credits in Music? Yes__ No__

Please list pre-registered courses. _______________, ______________________, ___________________, _____________________

5. Why have you chosen to study the Classical Music Track and why should you be selected as the Arthur
Chatfield Music Scholarship recipient (attach maximum 1/2 page response)?

6. Have you applied for other CCRI scholarships, funds or awards? Yes___ No___

If yes, please list:

I grant my permission to the Scholarship Review Committee to review my academic standing with CCRI’s Office of Admissions and Records, to review my financial need with CCRI’s Financial Aid Office, and to use my name and photo for publicity purposes.

______________________________________
Student Signature/Date

Important Note: Scholarship recipient is required to write a thank you note (memo and sample thank you note) to the scholarship donor, and provide a brief biography (printable bio form) about themselves and their education/career goals and return both to: Geraldine Peixoto, CCRI Foundation, Flanagan Campus, 1762 Louisquisset Pike, Lincoln, RI 02865. Please contact the CCRI Foundation if you need assistance in completing this responsibility at 333-7150 or e-mail at foundation@ccri.edu.

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