Theatre Scholarship Application and Registration for Scholarship Auditions

(at this time we are only accepting applicants from the United States)

Full Name:
Address:
City:		State	Zip
Phone:		Cell Phone
E-Mail Address
Date of Birth
Do You Have A High School Diploma?	Yes No
If Yes, Where From:
City:		State:	Zip:
Colleges Attended and Year
Current GPA
Check appropriate category	High School Senior College Transfer
Name of School
I will audition on	February 21, 2013 March 14, 2013 April 25, 2013 May 9, 2013
SAT score		ACT score
I wish to be considered in the following area(s)	Performance Production Both
Are you employed now/will you need to work while at Chipola?	Yes No
Have you applied for any type of Financial Aid?	Yes No
If so, explain:
Briefly list any previous employment experience: What other outside activities or groups do you participate in? List any honors or awards you have received: In addition to this form, please complete a Foundation Scholarship Application Form...

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3094 Indian Circle | Marianna, FL 32446 | Phone: (850) 526-2761 | Email Us