Child's Name ________________________ Years completed in YS __________

CYC _____ Performance _____ Apprentice ____ Training _____ IMM _____

Child lives with (check all that apply):

__ Father __ Mother __ Stepfather __ Stepmother __ Male Guardian __Female Guardian

Father, Stepfather, Male Guardian                 Mother, Stepmother, Female Guardian

Name _________________________         Name ____________________________

Address _______________________         Address __________________________

City & Zip _____________________        City & Zip ________________________

Home Phone ___________________                  Home Phone ______________________

Occupation ____________________                  Occupation _______________________

Employer ______________________        Employer _________________________

Address _______________________         Address __________________________

Business Phone _________________         Business Phone ____________________

How many OTHER dependent children do you have? ____________

How many OTHER tuition-charging activities is your child involved in? __________

Estimated amount of YS or YC tuition you are able to contribute for 2003-04 _________

Income (monthly)

Salaries and wages – Father, Stepfather, Male Guardian         _____________________

Salaries and wages – Mother, Stepmother, Female Guardian  _____________________

Other income (including alimony, child support, dividend

And/or interest income, business income, social security)  _______________________

Expenses (monthly)

Rent/mortgage, renters/homeowners insurance, utilities     _______________________

Automobile payments/insurance/gasoline/repairs               _______________________

Medical/dental/life insurance and expenses not covered     _______________________

Day care for children                                                            _______________________

Alimony/child support                                                _______________________

Food                                                                   _______________________

Other ____________________________________           _______________________

¨     Information included on this sheet will be held in the strictest confidence.

¨     Include with this form a letter describing specific reasons for seeking assistance.

¨     The Atlanta Young Singers of Callanwolde reserves the right to request a copy of last years 1040 Federal Tax return as verification of the information provided here. Failure to provide this form, if requested, will result in your application being denied.

Please complete and return, along with the signed, notarized affidavit by June 1, 2003 to:

AYSC

980 Briarcliff Rd., NE

Atlanta, GA  30306