Artist's Way Circle Scholarship Survey

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* 1. Address

Name

Email Address

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* 2. Tell me why you really need this course right now and what you would like to accomplish by participating.

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* 3. What are the major obstacles that you are experiencing that are keeping you from taking the course?

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* 4. Why should I choose you over any other individual for this scholarship?

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* 5. Which Circle are you applying for? (you can choose one or more)

Circle 1 starting May 7, Tuesdays 10am-12pm

Circle 2 starting June 4, Tuesdays 6-8pm

Circle 3 starting July 11, Thursdays 10am-12pm

Other (please specify)