THE MEDIA THEATRE
2018-2019 ACTING CLASS
AND CAMP MEDIA THEATRE SCHOLARSHIP APPLICATION
SCHOLARSHIP APPLICATIONS MAY BE SUBMITTED VIA EMAIL TO ROGER RICKER AT firstname.lastname@example.org
OR MAIL: THE MEDIA THEATRE, 104 E. STATE STREET, MEDIA, PA. 19063.
610-891-0100 | www.mediatheatre.org
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 GRADE IN SCHOOL
ETHNICITY OF APPLICANT (FOR INTERNAL PURPOSES ONLY—WILL NOT AFFECT THE REWARDING OF SCHOLARSHIPS)
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:
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.
PLEASE WRITE A BRIEF ESSAY ON WHY THE SCHOLARSHIP WOULD BE IMPORTANT TO YOU: