Heights Arts has a limited amount of financial aid available for the summer of 2009 for students under 18 years old. Your household income must fall below level 3 to be eligible. To apply please fill out the form below and mail it to Heights Arts, 2163 Lee Rd Ste 104, Cleveland Heights OH 44118.
If you have any questions please call 216-371-3457 or e-mail register@heightsarts.org

1. Please select number of persons in the household: (scroll down to find applicable answer) 2 3 4 5 6 7 8 9


2. Please select below which level your household* income falls according to the table below: (scroll down to find the applicable lowest level) *Household includes all persons living in your home. Level 1 Level 2 Level 3

   Income by household size eligible for reduced class fee.

   Household Income	2 person	3 person	4 person	5 person	6 person
   Level 1	$15,550	$17,500	$19,450	$21,000	$22,550
   Level 2	$25,900	$29,150	$32,400	$35,000	$37,600
   Level 3	$41,500	$46,650	$51,850	$56,000	$60,150

   Student first name:
   Student last name:
   First name parent/guardian:
   Last name parent/guardian:
   Address:
   City:
   State:
   Zip:
   Home Phone:
   Work Phone:
   Cell Phone:
   E-mail Address:
   Age:

   Name of the class for which you would like to receive financial aid:
   

   Parent/Guardian signature:

   Date: