Friends of the West Shore Theatre Inc. · Scholarship Application

Child's Name

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First Name

Last Name

Date of Birth

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(mm/dd/yyyy)

Age

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Grade Level (Entering 22/23 School Year)

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Grade 6

Grade 7

Grade 8

Grade 9

Grade 10

Grade 11

Registering Adult Name and Relationship to Applicant

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Address

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Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Primary Contact Phone

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Primary Contact Email Address

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Verify Email

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Please explain any information and/or circumstances which make the applicant unable to contribute to the workshop registration fee.

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Why and how do you feel this applicant would benefit from receiving a workshop scholarship?

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