AAHP Scholarship Application

Academy of Art of Highland Park & Gallery Inc. (AAHP)

727 Raritan Avenue, Highland Park, NJ 08904 USA

www.aahpnj.com (732) 777-2085

Scholarship Application
2019 - 20 School Year

Student's Name*

First NameLast Name

Sex*

Student Age*

Student is....*

Which eight-week Session will the student enter*

Name of Parent/Guardian

First NameLast Name

Relationship to Student *(if not parent)

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number*

Area CodePhone Number

Emergency Contact Name*

First NameLast Name

Emergency Contact Phone Number*

Area CodePhone Number

Name of Applicant's Case Worker (optional)

First NameLast Name

Case Worker's Phone Number (optional)

Area CodePhone Number

Name of Applicant's Doctor (optional)

First NameLast Name

Doctor's Phone Number (optional)

Area CodePhone Number

Is there anything we should know in confidentiality about the applicant’s medical history/needs?

Does the applicant have any aggressive or dangerous behavioral history that the Academy should know of for the safety of all those involved?

Our training is formal, but gentle, friendly and fun. We work to strengthen our student’s self-confidence, manual and visual skills, emotional well-being and pleasure in engaged, creative action. The art training is tailored to suit the applicant’s needs. Is there any type of concern about any presumed or unforseeable negative effects that our art training may have on the applicant? If so, please explain:

How might art lessons serve the applicant?

How did you/your organization find out about us?

Disclaimer

The Academy’s teaching staff consists of professional artists deeply trained in studio pedagogy. Though members of the AAHP staff have experience with special needs populations, none are certified in that capacity. As art instructors, we have served many students facing the challenges of brain injury, autism and autism-spectrum diagnoses, attention-deficit disorders, emotional upsets or trauma, and learning disabilities. If the applicant is developmentally or physically disable, or experiencing an emotional crisis, please call for more information. We place special needs students in very small classes where they can receive close attention from adult teaching staff and their teen assistants. We cannot deliver private classes to any student.

By signing below, the Applicant/Representative hereby acknowledges the Disclaimer noted above, and will also abide under the AAHP’s Agreement of Policies, Terms and Conditions. Parent or Sponsor’s.

Signature*