Destiny Live Center for the Performing Arts Scholarship
Application Form
Please Type or Write Clearly
Biographical Questionnaire (Please type) A. You, the Nominee Legal name in full
LAST___________________________________________________________________________________________________________________
FIRST__________________________________________________________________________________________________________________
M.I.___________________________________________________________________________________________________________________
Permanent Residence
STREET AND NUMBER_____________________________________________________________________________________________________
CITY___________________________________________________________________________________________________________________
STATE_________________________________________________________________________________________________________________
ZIP CODE_______________________________________________________________________________________________________________
(Permanent residence is established by at least two of the following: home address for school registration; place of registration to vote; family’s primary residence.)
If you are selected as a scholar, you will receive notification by mail.
BEST TELEPHONE _______________________________________________________________________________________________________
BEST EMAIL ADDRESS ___________________________________________________________________________________________________
ARE YOU: I HAVE BEEN ADMITTED
What graduate degree, if any, do you plan to pursue? ____________________________________________________________________________
1. Beginning with the school you currently attend, list all schools you attended in the last four years, including any for summer or special courses. You will have space to list 4 schools.
SCHOOL_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
LOCATION_____________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
DATES ATTENDED_______________________________________________________________________________________________________
GPA/GPA SCALE______________________________________________________________
2. List any awards, honors, or scholarships you have received in the past four years. Please list in descending order of significance. You will have space to list up to 6 awards.
NAME_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
DATE__________________________________________________________________________________________________________________
DESCRIPTION_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
D. Your Programs and Activities
1. List any programs and activities in which you have participated on campus or in your community while in school (such as clubs, publications, debate, dramatics, music, art, student government…). Please list in descending order of significance. You will have space to list up to 5 college activities and 4 high school activities.
COLLEGE ACTIVITY____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
DESCRIPTION/OFFICE HELD_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
DATES PARTICIPATED__________________________________________________________________________________________________________________________________________________________________________________________________________________________________
HIGH SCHOOL ACTIVITY____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2. List internships, assistantships, and jobs (including summer employment) you have held in the past four years. You will have space to list up to 4 employers.
JOB AND KIND OF WORK (SUMMER/SCHOOL YEAR)
EMPLOYER___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
DATES OF EMPLOYMENT___________________________________________________________________________________________________________________________________________________________________________________________________________________________________
HOURS PER WEEK___________________________________________________________________________________________________________________
3. List public service and community activities. Do not repeat items listed previously. Please list in descending order of significance. You will have space to list 4 activities.
ACTIVITY_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
ROLE__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
DATES__________________________________________________________________________________________________________________
#WEEKS________________________________________________________________________________________________________________
4. What additional information (not already addressed in the application) do you wish to share with the Destiny Live Center Music Scholarship review committee? (Limit 1100 characters with spaces)
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
E. Essay (Please attach.)In 800 words or less, discuss a significant impact on your field of study, interests, and career goals.
Please submit application to Destiny Live Center for the Performing Arts
Destiny Live Center for the Performing Arts @The Hive CTS
1000 W 42nd St.
Indianapolis, IN 46208
For Information Contact Priscilla Bolden 317-222-0187
Application Form
Please Type or Write Clearly
Biographical Questionnaire (Please type) A. You, the Nominee Legal name in full
LAST___________________________________________________________________________________________________________________
FIRST__________________________________________________________________________________________________________________
M.I.___________________________________________________________________________________________________________________
Permanent Residence
STREET AND NUMBER_____________________________________________________________________________________________________
CITY___________________________________________________________________________________________________________________
STATE_________________________________________________________________________________________________________________
ZIP CODE_______________________________________________________________________________________________________________
(Permanent residence is established by at least two of the following: home address for school registration; place of registration to vote; family’s primary residence.)
If you are selected as a scholar, you will receive notification by mail.
BEST TELEPHONE _______________________________________________________________________________________________________
BEST EMAIL ADDRESS ___________________________________________________________________________________________________
ARE YOU: I HAVE BEEN ADMITTED
What graduate degree, if any, do you plan to pursue? ____________________________________________________________________________
1. Beginning with the school you currently attend, list all schools you attended in the last four years, including any for summer or special courses. You will have space to list 4 schools.
SCHOOL_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
LOCATION_____________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
DATES ATTENDED_______________________________________________________________________________________________________
GPA/GPA SCALE______________________________________________________________
2. List any awards, honors, or scholarships you have received in the past four years. Please list in descending order of significance. You will have space to list up to 6 awards.
NAME_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
DATE__________________________________________________________________________________________________________________
DESCRIPTION_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
D. Your Programs and Activities
1. List any programs and activities in which you have participated on campus or in your community while in school (such as clubs, publications, debate, dramatics, music, art, student government…). Please list in descending order of significance. You will have space to list up to 5 college activities and 4 high school activities.
COLLEGE ACTIVITY____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
DESCRIPTION/OFFICE HELD_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
DATES PARTICIPATED__________________________________________________________________________________________________________________________________________________________________________________________________________________________________
HIGH SCHOOL ACTIVITY____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2. List internships, assistantships, and jobs (including summer employment) you have held in the past four years. You will have space to list up to 4 employers.
JOB AND KIND OF WORK (SUMMER/SCHOOL YEAR)
EMPLOYER___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
DATES OF EMPLOYMENT___________________________________________________________________________________________________________________________________________________________________________________________________________________________________
HOURS PER WEEK___________________________________________________________________________________________________________________
3. List public service and community activities. Do not repeat items listed previously. Please list in descending order of significance. You will have space to list 4 activities.
ACTIVITY_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
ROLE__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
DATES__________________________________________________________________________________________________________________
#WEEKS________________________________________________________________________________________________________________
4. What additional information (not already addressed in the application) do you wish to share with the Destiny Live Center Music Scholarship review committee? (Limit 1100 characters with spaces)
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
E. Essay (Please attach.)In 800 words or less, discuss a significant impact on your field of study, interests, and career goals.
Please submit application to Destiny Live Center for the Performing Arts
Destiny Live Center for the Performing Arts @The Hive CTS
1000 W 42nd St.
Indianapolis, IN 46208
For Information Contact Priscilla Bolden 317-222-0187
