Summer Intensives Scholarship Application

Date
MM slash DD slash YYYY
Student Information
Student's Name*
Name of student attending course
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Student's Cell Phone Number*
Student's Home Phone Number (if applicable)
Student's Email Address*
Enter Email Confirm Email
Is email an effective means of communication with you?*
- Yes
- No
Student's Pronouns
- she/her
- he/him
- they/them
Check all that apply
Student's Birth Date*
MM slash DD slash YYYY
Student's Age as of July 2024*
Summer Intensives are for students aged 12-17. Pro Series are for students aged 14-18.
Student's School*

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Two River Theater