TWIN LAKES PLAYHOUSE SCHOLARSHIP APPLICATION

FOR THE PERFORMING ARTS

This application is for high school graduating seniors who are planning to pursue a degree in some aspect of the performing arts at an accredited school, as well as college students continuing an undergraduate performing arts education.

DEADLINE: This application must be completed and returned along with a high school or college transcript by June 1, 2008 to: Shirley Spitzer, 606 Ridgewood Drive, Mountain Home, AR 72653

Name:_____________________________________________________________

Address: __________________________________________________________

Telephone No.:______________________ Email Address____________________

What school do you plan to attend?______________________________________

____________________________________________________________________

Have you been accepted?_______________________________________________

Telephone number of school:____________________________________________

1. On a separate sheet of paper, please write a few paragraphs describing A) your future educational plans, B) the influential factors in your decision to further your education in the performing arts and C) your future career goals in the performing arts.

2. College entrance examination score (if applicable): ACT composite score______ or SAT combined score_____

3. Cumulative grade point average (GPA).__________________________________________

4. In what aspect of the performing arts do you plan to get your degree?_________________

5. In what performing arts have you been involved, such as choir, band, debate, etc._______

_________________________________________________________________________

6. In what theater activities have you been involved, such as acting, stage crew, set design, etc.?

Please be thorough. Use extra paper if needed_______________________________

______________________________________________________________________

______________________________________________________________________

_______________________________________________________________________

______________________________________________________________________

_______________________________________________________________________

7. Financial need: In the space provided please indicate your family's adjusted gross income from

last year's tax return

______ Under $15,000 ______ $30,000 to $35,000

______ $15,000 to $20,000 ______ $35,000 to $50,000

______ $20,000 to $25,000 ______ $50,000 to $60,000

______ $25,000 to $30,000 ______ over $60,000

8. Number of dependents in your family including yourself._____________________

9. Children:_________ Ages:_____________ No. attending college:_____________

10. Other financial considerations which need to be noted:_____________________

_____________________________________________________________________

____________________________________________________________________

a. Will your family or some person be able to assist you with school expenses?

Completely: Yes______ No______ Partially: Yes______ No______

b. How do you intend to supplement your income for school expenses?________

___________________________________________________________________

c. Other scholarships you are receiving this school year:____________________

__________________________________________________________________

11. Extracurricular activities - organizations and clubs. Show years of involvement and indicate any

offices held. ( Use extra paper if needed.)_________________________________

____________________________________________________________________

__________________________________________________________________

12. Honors and awards:_______________________________________________

_______________________________________________________________________

13. Community or other activities:___________________________________________

_______________________________________________________________________

 

14. Work activities: Are you currently employed? Yes___ No___. If yes, what type of work are you doing and how many hours per week are you working?_________________________________

__________________________________________________________________________

15. Describe your other work and family activities or responsibilities. (Such as family farm, helping at home or family business.) ____________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

16. Please include the names, addresses, and phone numbers of two references, other than relatives, you have known for at least two years:

______________________________________________________________________

______________________________________________________________________

Applicant Signature_____________________________________________________

Parent or Guardian Signature_____________________________________________

THIS AWARD MUST BE RETURNED TO THE TWIN LAKES PLAYHOUSE IF THE STUDENT DOES NOT COMPLETE AT LEAST ONE YEAR OF ACADEMIC WORK IN THE PERFORMING ARTS FIELD AFTER THE AWARD HAS BEEN GRANTED.