Anthony Quinn Scholarship 2012 Nomination Application The deadline for nominations is November 15, 2011. Funds awarded must be expended by August 31, 2012. Nominee’s Information Nominee’s Full Name* Prefix First Name Last Name Street Address Line 1* Street Address Line 2 City/Town* State/Province* Zip/Postal Code* Country* Phone Number* - Area Code Phone Number E-mail* What is the specific arts program for which the nominee would be seeking scholarship funds?* Field of Interest of the Nominee:* Current School:* Grade Level* 9 10 11 12 Nominator’s Information Nominator’s Full Name* Prefix First Name Last Name Street Address Line 1* Street Address Line 2 City/Town* State/Province* Zip/Postal Code* Country* Phone Number* - Area Code Phone Number E-mail* Title* Organization* Professional Affiliations/Areas of Expertise:* In what capacity have you known the nominee?* How long have you known the nominee?* Please indicate if you have a family connection to the nominee:* In 150 words or less please explain the following: What is the principal reason you are proposing the nominee for the Anthony Quinn Foundation Scholarship Award? How would the nominee benefit from financial assistance?* Please review the description of the scholarship program and note the selection criteria before submitting. 0/150 Submit Application Should be Empty:
