American Guild of Organists
Pipe Organ Encounters
2012 POE Scholarship Application

This application contains two sections: Section I (student) and Section II (parent/guardian). This application cannot be processed if any line is left blank or any required question left unanswered. The data collected in this application is for use by the American Guild of Organists and will not be shared with or transmitted to any third parties.

Please review the information requested in this form and gather all necessary materials before starting the application process. This form cannot be started and saved for completion at a later time.

Financial aid is awarded for tuition only, not for travel or other expenses. Student scholarship awards are made for no more than one POE per year. Students cannot apply for assistance to attend a second or third POE in the same year.

Please complete the following fields and click Send when finished. It is recommended that you print a copy of this completed application for your records before pressing Send.
SECTION I | Student Information
This portion is to be completed by the Student.
First Name
Last Name
Permanent Home Address
Street
City
State
Zip
Home Telephone
Mobile Telephone
E-mail Address
Date of Birth (MM/DD/YYYY)
Current Grade in School





Twelfth
Expected Graduation Date (MM/YY)
Are you a current member of the AGO? Yes No
Have you attended a POE previously?     Yes No
Please answer the following questions using complete sentences.
Please explain why you want to attend a Pipe Organ Encounter.
What musical instruments have you studied and for how long?
Why are you seeking a scholarship?
Have you received or do you expect to receive any other scholarship awards or financial assistance in connection with your participation in this POE? If so, please list the sources and amounts of funding that have been provided.
Please add any other information you would like to provide regarding your need for financial assistance.
Amount of scholarship aid you are requesting
(amount awarded may not be amount requested)		 $ .00
Have you received AGO scholarship aid for a POE previously? Yes No
Have you received any other scholarship assistance previously? Yes No
Please provide the following information about the Teacher who will be providing a recommendation for the Student. It is the Student's responsibility to make sure that the Teacher has the link to the online recommendation form.
Name
Telephone Number
E-mail Address
Please complete the final portion of the Student Information section below.
You must select a POE location before proceeding with this application.
Only one location may be selected.
Location of POE attending
By checking this box and typing my name in the box below, I attest that the above information is true and accurate.

I agree


Student
If you have information that you feel is important to your scholarship application that was not addressed by this form, please feel free to direct further questions or comments to the CONO Director Denise Lanning at deniselanning@netscape.net.
SECTION II | Parent/Guardian Information
This portion is to be completed by the Parent/Guardian of the Student.
First Name
Last Name
Daytime Telephone
Mobile Telephone
E-mail Address
Occupation
Secondary Occupation (if any)
Combined household annual income $
Total number of persons in household
Please add any other information you would like to provide regarding the Student's need for financial assistance.
By checking this box and typing my name in the box below, I attest that the above information is true and accurate.

I agree


Parent/Guardian
Date (MM/DD/YYYY)