Form

SCHOLARSHIP APPLICATION FORM
All information is confidential and will be reviewed by the scholarship committee.
PERSONAL INFORMATION
Date *

Month Day Year
Full Name *

First Name Middle Name Last Name

Address *

Theatre Address: *

# of years employed at this theatre or with the company: *
Theatre manager's name: *
Position at theatre *
Experience at other theatres: *
Please submit a recommendation letter from your General Manager.
(Must be submitted in order to be considered.)
Recommendation Letter *
Current High School or College *

Address *

Parent's Address *

FAMILY INFORMATION
Father's Occupation *
Father's Employer *
Mother's Occupation *
Mother's Employer *
Annual household income (combined) *
Do you receive any type of benefits or income? *

Yes No
If yes, please explain:
Are there any financial burdens taht you and your family are faced with? *
SCHOOL INFORMATION
Please verify with school records:
SAT Scores:
Verbal: *
Math: *
Grade point average: *
Ask the manager of the theatre you are employed at or your parent is employed at for a reference letter. (All applications must come complete with such a reference to be considered)
Your Career Choice: *
Please list any personal reasons why you feel you should win this scholarship. *
Should be Empty:

SCHOLARSHIP APPLICATION FORM