Welcome to the World of Painting
Art In The Mountains  PO Box 311, Mehama, OR 97384
Please explain why you should be chosen to receive this scholarship based on the
given criteria.
2012 AITM Art Scholarship Application
PRINT, Complete and MAIL your Application by May 1, 2012 to:
Name:
 _________________________________
 Please list any type of art you have done.
Address:
 _________________________________
 __________________________________
City, State, Zip:
 _________________________________
 __________________________________
Phone:
 _________________________________
 __________________________________
Cell:
 _________________________________
 __________________________________
E-Mail:
 _________________________________
 __________________________________

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Household Income

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 Initial giving consent to let Art in the Mountains:
- share your name and address with the donor if the donor is other than Art in the Mountains.

- place a congratulations notation on our website mentioning your first name (picture optional)

Do you have transportation to and from the workshop at
the Phoenix Inn Suites, 300 Franklin, Bend, OR

Your Age?       Are you a beginning artist?______________________
I have read and agree to the application criteria. Signature _______________________________