Download Scholarship Application - Royal Regiment

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The Herbert Zipper Scholars program offers highly-gifted, low-income students the opportunity to advance as musicians, by providing
instruction and support to the “whole student.” Herbert Zipper Scholars receive instruction in music theory, private lessons, ensemble
participation, as well as many other opportunities. This program is made possible by the Jack Kent Cooke Foundation.
Application Information
The student must be entering their senior year of high school or younger and a minimum age of 10. Student must possess a high level of
interest and commitment to musical study. Some experience and background is necessary. Two years of experience on student’s instrument
and participation in a school ensemble (if applicable) strongly encouraged. Student will be expected to complete a written application
and an audition. In addition, the student and guardian will be asked to participate in an interview.
Application Requirements
Copy of last report card
Music Theory placement test (test attached; please fill out and return with application and all other supplemental materials.)
Student must complete an essay on one of the following topics:
1) Tell us about someone you admire and how they have impacted your life
2) Describe your goals and plans following your high school graduation
Submit two letters of recommendation. Ideally, one would be from an academic teacher and one from a music teacher.
Complete Financial Aid Application with all supporting documents
Audition Information
After submitting all application materials, selected students will be contacted to schedule an audition and interview.
Instrumental Audition Requirements
Perform a solo piece of your choosing (accompanist optional)
Student will be asked to play scales and sight-read
Vocal Audition Requirements
For 8th grade and younger: 1 song of student’s choice in either classical or musical theater style (accompanist optional)
For 9th grade and up: 2 songs of contrasting styles. Suggested: 1 art song in a foreign language (Italian preferred, accompanist optional)
Jazz Instrumental Requirements
Two solo pieces: one must be a jazz standard and one may be anything within the jazz genre, including an original composition.
Pieces should be in contrasting styles. Improvisation must be included. (Accompanist or backing tracks optional)
Student will be asked to play scales and sight-read
Please return application and all materials to the Colburn Community School of Performing Arts
Registration Office by 5:00 pm on March 22, 2013.
Application may be returned in person or via mail, fax, or email to Abigail Caro:
The Colburn Community School of Performing Arts
c/o Abigail Caro
200 South Grand Avenue
Los Angeles, ca 90012
phone: 213.621.4546
fax: 213.621.2110
email: acaro@colburnschool.edu
200 South Grand Avenue, Los Angeles, ca 90012 www.colburnschool.edu

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Application
Year: _________________________ Fall Spring New Student Colburn Student Male Female
Student Information
Last Name:
First Name:
Birthdate:
Address:
State:
Zip:
Home phone: ( ) Cell: ( )
Email:
School currently attending:
Current grade level:
Home School Student
City:
Primary Contact Information
Last Name: First Name: Mr. Mrs. Ms. Dr.
Relationship (mother/father/etc.):
Home phone: ( ) Cell: ( )
Email:
Address (if different from above):
City:
State:
Zip:
t
Student signature:
Parent signature:
Date:
Date:
200 South Grand Avenue, Los Angeles, ca 90012 www.colburnschool.edu

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Date ___________________________
The Colburn School
Financial Aid Information Form – Confidential
The information requested in this form is used in the determination of need-based Financial Aid for students
enrolled in the Community School of Performing Arts. This form must be completed in its entirety, and the
following supporting documents must be attached before submitting this form:
The family’s most recent U.S. income tax return (Form 1040).
Current W-2 forms and other records of monies earned.
Records of non-taxable income such as veterans, social security, AFDC or ADC, or welfare benefits.
Records of current medical and dental expenses not covered by insurance.
This completed form must be returned to the Colburn School address below:
The Colburn Community School of Performing Arts, c/o Abigail Caro
200 South Grand Avenue
Los Angeles, CA 90012
Student Information
_______________________________________________________________________________________________________________________________________________________________________________________________
Last name First Name Middle Name
____________________________________________________________________________________________________ Male Female
Age and Date of Birth
_______________________________________________________________________________________________________________________________________________________________________________________________
Student’s Mailing Address (Street, City, State, Zip)
___________________________________________________________________________________
Home Phone
____________________________________________________________________________
Cell Phone
_______________________________________________________________________________________________________________________________________________________________________________________________
Name of Current Academic School
Grade
_______________________________________________________________________________________________________________________________________________________________________________________________
Ethnicity (optional, this is confidential information gathered for statistical purposes)
What is your area of interest in the performing arts? ______________________________________________________________________________________________________
How long have you studied this art? _________________________________________________________________________________________________________________________________
List your most recent teachers in this art:
_______________________________________________________________________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________________________________________________________________
List any ensembles or groups in this area to which you belong:
_______________________________________________________________________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________________________________________________________________
200 South Grand Avenue, Los Angeles, ca 90012 www.colburnschool.edu

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Family Information
_________________________________________________________________________________________________
Name of Mother/Stepmother/Foster Mother
_________________________________________________________________________________________________
Employer
_________________________________________________________________________________________________
Name of Father/Stepfather/Foster Father
_________________________________________________________________________________________________
Employer
_____________________________________________________________________________
Occupation
_____________________________________________________________________________
Work Phone
_____________________________________________________________________________
Occupation
_____________________________________________________________________________
Work Phone
Parents’ Marital Status: Married Divorced Widowed Single
Family Size (List number dependents): _________________________ Adults (18 yrs and older) __________________________Children (under 18 yrs)
Financial Information
Families are eligible if total annual income is under $45,000 or if experiencing extenuating circumstances, such as job loss, medical bills
not covered by insurance, etc.
Parents’ Annual Income
Wages, salaries, tips (before taxes)
Mother
Father
Adjusted Gross Income (from attached tax return)
$_________________________________________________
$_________________________________________________
$_________________________________________________
Family’s Monthly Expenses
Housing (monthly) owned rented $_________________________________________________
Insurance (1/12 of annual premium)
$_________________________________________________
Medical/dental expenses not covered by insurance $_________________________________________________
Food (average monthly cost)
$_________________________________________________
Tuition (total of all children) – academic
$_________________________________________________
Tuition (total of all children) – performing arts
$_________________________________________________
Other recurring expenses
$_________________________________________________
Assets (as of date of this application)
Cash, savings and checking accounts
Home equity (renters enter $00)
$_________________________________________________
$_________________________________________________
t
Present value
Amount owed
Other real estate and investments $_________________________________________________ $_________________________________________________
Business or farm $_________________________________________________ $_________________________________________________
Automobiles
Year __________________ model _________________________ $_________________________________________________ $_________________________________________________
Year __________________ model _________________________ $_________________________________________________ $_________________________________________________
Please use an additional sheet to describe as fully as possible any extenuating circumstances relative to your request for financial assistance/scholarship.
Certification
I certify that the information presented in this application is true and correct.
_______________________________________________________________________________________________________________________________________________
Print Name of Parent/Guardian
_______________________________________________________________________________________________________________________________________________
Signature of Parent/Guardian
Date
200 South Grand Avenue, Los Angeles, ca 90012 www.colburnschool.edu

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The Colburn Community School of Performing Arts
Music Theory Placement Evaluation
Please print all information.
Name ____________________________________________________________________________________________________ Date __________________________
Age ________________ Grade in School ________________ Instrument _________________________________________________________
Phone Number ___________________________________________________________________________________________________________________________
Email Address ____________________________________________________________________________________________________________________________
The following evaluation is used for placement purposes only. This is not a test, and no grade
will be given. Answer as many questions as you can, and leave the others blank. Take as
much time as you need. Thank you.
200 South Grand Avenue, Los Angeles, ca 90012 www.colburnschool.edu

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