Student Summer School Scholarship Application

Student Information
Student Name:*
First Last
Student Date of Birth:*
MM slash DD slash YYYY
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone
Cell Phone
Parent/Guardian 1 Name
First Last
Email
Parent/Guardian 2 Name
First Last
Email
Sponsoring Teacher:*
First Last
Most Recent CCA Exam Passed:*
Years of Ballet Training
Please check all other dance classes you take:
- Partnering
- Jazz
- Modern
- Musical Theatre
- HipHop
- Tap
Photo in 1st Arabesque*
Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 50 MB.
Photo in 2nd position tendu*
Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 50 MB.
Video of adage, pirouette, and allegro combinations*
Drop files here or

Accepted file types: mp4, Max. file size: 50 MB.
Application Fee Quantity*
Price: $25.00
Total
$0.00
Credit Card*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Credit Card Billing Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
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Student Information