SCHOLARSHIP APPLICATION

In support of performing arts and as a community service to children who wish to participate in
classes/workshops sponsored by Pacific Repertory Theatre’s School of Dramatic Arts we offer partial
tuition assistance. Your scholarship application will be considered based on available funds and your
need. Please complete the entire form below.

CLASS(ES):_________________________________________AMOUNT REQUESTED ________

STUDENT NAME:_____________________________________________BIRTHDATE:_______
GRADE:_____AGE:_____SCHOOL___________________________MALE______FEMALE_____

In order to make it possible for P.R.T./SoDA to obtain grants we need the following infor-
mation:

Check one (optional): African American____ Hispanic/Latino___ Native American____ Asian/

Pacific____ White/Other____

1. List performing arts experience that you have had including # of years, teacher and city:
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________

2. Are you willing to consistently attend and participate in the class or workshop that is covered
by this scholarship?
______________________________________________________________________

3. Please tell us about yourself and why you would like to be considered for tuition funding (both
the student and parent or guardian should respond to this request). You may use the
area below and/or the back of this page.
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________

STUDENT SIGNATURE:______________________________DATE:______________________
PARENTS NAMES:______________________________________________________________
ADDRESS:____________________________________________________________________
HOME PHONE______________WORK PHONE:________________E-MAIL________________

Pacific Repertory Theatre’s School of Dramatic Arts is a nonprofit organization