ACTING CLASS and CAMP SCHOLARSHIP APPLICATION (2019)

THE MEDIA THEATRE

2018-2019 ACTING CLASS

AND CAMP MEDIA THEATRE SCHOLARSHIP APPLICATION

SCHOLARSHIP APPLICATIONS MAY BE SUBMITTED VIA EMAIL TO ROGER RICKER AT rer764@gmail.com

OR MAIL: THE MEDIA THEATRE, 104 E. STATE STREET, MEDIA, PA. 19063.

Scholarships are awarded based on need and availability. Applicants from age 6 to 15 may apply.

If awarded a scholarship, the amount you receive (whether a full or a percentage) will be based on your application information.

PLEASE FILL OUT THE INFORMATION BELOW:

NAME OF APPLICANT

____________________________________________

APPLICANT’S PARENT’S NAME/ CONTACT

________________________________________________________

APPLICANT AGE

___________

APPLICANT GRADE IN SCHOOL

___________

ETHNICITY OF APPLICANT (FOR INTERNAL PURPOSES ONLY—WILL NOT AFFECT THE REWARDING OF SCHOLARSHIPS)

___________________________________

MAILING ADDRESS

______________________________________________

EMAIL ADDRESS OF PARENT CONTACT______________________________

PHONE NUMBER OF PARENT CONTACT______________________________

EMPLOYER OF PARENT CONTACT___________________________________

PHONE NUMBER OF EMPLOYER ____________________________________

NUMBER OF ADULTS IN HOUSEHOLD _______

NUMBER OF CHILDREN IN HOUSEHOLD _______

DOES THE APPLICANT HAVE ANY MEDICAL CONDITIONS, SPECIAL NEEDS, OR ALLERGIES WE NEED TO BE AWARE OF? IF YES, PLEASE EXPLAIN BELOW:

HAS THE APPLICANT PARTICIPATED IN THE MEDIA THEATRE’S EDUCATION PROGRAM PREVIOUSLY? __________________________

HAS THE APPLICANT RECEIVED A SCHOLARSHIP TO THE MEDIA THEATRE’S EDUCATION PROGRAM PREVIOUSLY? __________________

PLEASE EXPLAIN, IN AS MUCH DETAIL AS POSSIBLE, FINANCIAL CIRCUMSTANCES TO BE CONSIDERED BELOW:

Please Note:

Scholarship awardees may be asked to perform camp assistant responsibilities as a portion of their scholarship fulfillment.

Scholarship awardees will be expected to fulfill the dates and times of the camp/semester. Scholarships may be revoked if there is a failure to comply.

Those determined eligible will need to fulfill a live interview/ audition with The Media Theatre’s Artistic Director in order to receive the scholarship.

CANDIDATE,

PLEASE WRITE A BRIEF ESSAY ON WHY THE SCHOLARSHIP WOULD BE IMPORTANT TO YOU: