CAC SUMMER ARTS CAMP SCHOLARSHIP APPLICATION
POSTMARK DEADLINE: MAY 1, 2015
PLEASE COMPLETE THIS FORM AND SUBMIT TO:
CAC Education Department
900 Camp Street
New Orleans, LA 70128
Date of completed application: _______________________________________
Summer Camp Scholarship Guidelines:
 Incomplete applications will not be reviewed.
 Scholarships will be awarded based upon need and merit.
 Applicants are evaluated without regard to race, religion, natural origin, sex, or physical ability.
 Funding is limited and scholarships are not guaranteed to all applicants.
 Scholarships are only available for one week of camp. Aftercare and CAC Membership are not included.
Please fill out one form per child.
Name of Child ___________________________________________________ Birthdate______/_______/_______
Mailing Address________________________________________________________________________________
City___________________________________________________ State _______________ Zip_______________
Phone (___________) _________________________ Family Email ______________________________________
Grade _____________________________________School ____________________________________________
Need Type:
 Need
 Merit
Scholarship Type:
 Partial Scholarship
 Full Scholarship
Please select the camp week you are applying for:
 July 6—10
 July 13—17
 July 20—24
 July 27—31
How many children currently live in the household? ________ Please list their ages: _________________________
Do you currently have a CAC Membership? □ Yes □ No If yes, list Membership expiration date: _______________
REQUIRED FAMILY INFORMATION
Name of Parent or Legal Guardian _________________________________________________________________
Mailing Address________________________________________________________________________________
City __________________________________________________ State _______________ Zip________________
Phone (___________) _________________________ Email ____________________________________________
Place of Employment ____________________________________________________________________________
Occupation ____________________________________________________________________________________
FINANCIAL INFORMATION
Eligibility for need-based scholarships is based on the following criteria and conditions, including household size* and
income standards. If an applicant does not fall within these criteria, but can prove other special circumstances, the
scholarship committee will review and may grant a scholarship.
*Household includes all people (adults and
children) living in the household, related or
not (grandparents, other relatives, friends,
etc.).
Total Household Size*
2
3
4
5
6
7
8
Yearly Income
$25,900
$32,560
$39,220
$45,880
$52,540
$59,200
$65,860
Monthly Income
$2,159
$2,714
$3,269
$3,824
$4,379
$4,934
$5,489
Please indicate your total annual household income from all sources (including wages, interest income, investments,
alimony, child support, social security, public assistance):
 Below $10,000
 $20,001-$25,000
 $35,001-$40,000
 $50,001-$55,000
 $10,001-$15,000
 $25,001-$30,000
 $40,001-$45,000
 $55,001-$60,000
 $15,001-$20,000
 $30,001-$35,000
 $45,001-$50,000
 $65,001-$70,000
 Over $70,000
Does your child qualify for free or reduced lunch?  Yes  No
Are there any extenuating circumstances, permanent or temporary, that make financial assistance necessary at this
time? ________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
What do you hope your child will gain from this experience? _____________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
What is your previous experience at the Contemporary Arts Center? ______________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Has anyone in your family previously received assistance through our scholarship program?  Yes  No
If yes, when? ___________________________ How much was received? $________________________________
Scholarship recipients will be notified by May 11, 2015.