Hip Hop Dance Class Bursary Form

We have two bursary places available for Hip Hop Dance Class. Bursaries provide free spaces in all sessions scheduled from April until July.
Please fill in the following application and we will be in touch within 10 days.
In order for us to review your current situation as impartially as possible, please complete this form and provide details of your current situation with as much detail as possible.   Due to the confidential nature of this document, the information you provide on this form is kept on file for one year only.  
Name(Required)
 
 
 
 
Home Address(Required)
 
We don't want to be nosey, but we do want to make sure that these places are going to people who will directly benefit. We won't ask for the documents, but it would be useful to know if you receive any of the following(Required)
 
Can you attend every Wednesday Hip Hop Dance Class Session, 7.30-9pm from 17 Apr – 17 Jul ?
Other than an illness or doctors appointments etc. There will be no session on the 26th June.
 
 
I declare that the information I have provided on this form is true and correct to the best of my knowledge. I understand that purposefully giving false information will automatically disqualify me for any financial assistance from the Mercury Theatre, I also understand that completion of this application does not guarantee that I will receive the financial support that I have applied for. I understand that all applications are processed subject to availability of funds and eligibility criteria.(Required)