SAGE - New York City Programs - Lifelong Learning Scholarship Form

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Which course(s) have you applied for?* Creative Writing (Starts: 2/25/13) Creative Writing Mini (Starts: 2/26/13) Musical Theatre Writing Workshop (Starts: 1/31/13) Creative Writing Intensive (Starts: 2/13/13) Genealogy Tips & Tricks (Starts: 2/16/13) Spanish (Starts: 2/21/13) ElderSpirit (Starts: 2/2/13) Anyone Can Draw (Starts: 3/4/13) Digital Film Editing (Starts: 2/22/13) Presence of the Past: Judeo Ethics (Starts: 2/26/13) Are you a SAGE Member?* Yes No If YES, when does your membership card expire?* Are you a SAGE Client (do you have a SAGE social worker)?* Yes No What is your age?* Are you currently receiving any of the following?* SSI/SSD Food Stamps Section 8 Housing Subsidy Unemployment Compensation Other public assistance What is your approximate monthly income?* What are your approximate monthly expenses?* If you DO NOT receive a scholarship, will you be able to take this course(s)?* Yes No Is there anything else you would like us to know?

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Scholarship Application