John Potter Youth Music Scholarship Application

2016 John Potter Youth Music Scholarship Application

Crossroads Music will award a scholarship to attend the Centrum Acoustic Blues Workshop. Recipient must be 18 years of age or younger. Scholarship Valued at $570.00

Crossroads Music will be awarding a music scholarship to one person in honor of our dear friend and teacher John Potter who passed in 2013. He taught at Crossroads Music for 16 years and gave so much of his time to teaching so many in this community and helping continue Port Townsend’s heritage as an arts community. Music was a deep passion for John and he believed in its power to transform lives.

Scholarship application form

Name: ___________________________________________________________

Address: ______________________________________________________________________________________

Phone: ___________________________________________________________

Email: ___________________________________________________________

Age: ________________

Number of years playing: ________ (if applicable)

Why would you like to attend the Blues Workshop? / What are your musical goals, interests and reasons for seeking this scholarship?
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

Please be aware of the following Centrum requirement to attend if under-18 years of age. You must be accompanied by an adult that is a registered participant, or chaperone. There is no registration for a non-participating chaperone. With your parent or guardian’s permission, a registered adult attending the workshop can be your chaperone or an adult chaperone not attending can accompany you and not participate in the workshop. For more details on the workshop please visit centrum.org

Applicant Signature:__________________________________________

Parent / Guardian Name: _______________________________________

Parent / Guardian Signature: _____________________________________

Parent Phone Number:___________________________________________

Scholarship info
• The scholarship is open to all types of musicians, including vocalists, guitar, uke, banjo, piano players and any type of instrument taught at the Centrum workshops.
• The scholarship funds are for tuition only to attend the Port Townsend Acoustic Blues Workshop, July 31-August 7, 2016.
• Applicant must be 18 years of age or younger.
• Must be a resident of Jefferson County or Clallam County, Washington.
• One person will be chosen to receive the scholarship. If the recipient cannot attend the workshop, the scholarship will be awarded to another applicant.

Deadline, Submission & Notification

• DEADLINE: The deadline to submit your application is July 1, 2016.
• SUBMISSION: Submit your application at Crossroads Music by person or by mail to
2100 Lawrence Street, Port Townsend, WA 98368
• NOTIFICATION: The scholarship will be awarded by July 6th, 2016.

Crossroads Music, 2100 Lawrence Street, Port Townsend, WA.
Open: Monday – Friday, 10:00am-6:00pm
Saturday, Noon-4:00pm
Phone: 360.385.1471 | email: info@crossroads-music.com