Youth Theatre Scholarship FORM | Midland Center For The Arts

Student Name *

Home Address *

Home Phone *

Cell Phone *

Student Email *

Father's Name (Guardian) *

Mother's Name (Guardian) *

Are you currently in... *

High School Middle School Elementary School

Most Recent School Attended *

What Grade Are You Currently In? *

School Address *

School or Program Where Scholarship Will be Used *

Your Student ID Number with the School or Program *

Address to Mail the Scholarship, If Awarded *

Please List School Activities, Organizations, Offices Held, Awards, Athletics You Have Been Involved In *

College Intended Major(s), Minor(s), Field(s) of Study *

Youth Theatre Show(s) You Have Participated In (Indicate actor, backstage, usher, etc) *

Other Youth Theatre Activities *

Transcript or Report Card Upload *

Upload a Photo of Yourself *

Have You Applied for a Youth Theatre Scholarship Before? *

Yes No

Please List Any Further Information That Will Aid Committee Consideration of Your Application *

Youth Theatre Scholarship