1

The Childrens Theatre Company Center for Innovation in Theatre Education

Scholarship Request Form Summer Session: June 10th August 16th, 2013
To apply for financial aid, please submit the following items to the CTC Theatre Arts Training office:

One (1) completed copy of Scholarship Request Form (Pages 2-6) One (1) copy of your most recent income tax return. o Please note: Only the page showing your Adjusted Gross Income (AGI) is required (The 1st page of most 1040s) One (1) copy of the Letter of Agreement signed by both the student and a parent/guardian. (Page 7)

Please do not include a registration form or payment for camps.

PLEASE NOTE: Your application will not be considered complete until all items have been received. Incomplete applications will not be eligible for financial aid.

Please complete the entire form and return to: Debra Baron Theatre Arts Training Director 2400 3rd Ave S. Minneapolis, MN 55404 dbaron@childrenstheatre.org

The Childrens Theatre Company

2400 Third Avenue S

Minneapolis, MN

55404

(fax) 612.874.8119

Scholarship Request Form

Please indicate the camp(s) you are planning on enrolling in below:

Select
Ages 4, 5

Camp Title
Disney Legends Pinkalicious The Mighty Mice of Kevin Henkes Wild Things! Don't Let the Pigeon Drive the Bus (and others from the series) Olivia Dances For Joy Welcome to the Jungle A Bug's Life Tickled Pink Puppet Pizazz!

Dates
July 8-12 July 8-12 July 15-19 July 15-19 July 22-26 July 22-26 July 29 - August 2 July 29 - August 2 August 5-9 August 5-9 June 10-14 June 10-14 June 17-21 June 17-21 June 24-28 June 24-28 July 8-12 July 8-12 July 15-19 July 15-19 July 22-26 July 22-26 July 29-August 2 July 29-August 2 August 5-9 August 5-9 June 10-14 June 10-14 June 17-21 June 17-21

Times
9:30am 11am 2:30pm 4pm 9:30am 11am 2:30pm 4pm 9:30am 11am 2:30pm 4pm 9:30am 11am 2:30pm 4pm 9:30am 11am 2:30pm 4pm 9:30am 12noon 1pm 3:30pm 9:30am 12noon 1pm 3:30pm 9:30am 12noon 1pm 3:30pm 9:30am 12noon 1pm 3:30pm 9:30am 12noon 1pm 3:30pm 9:30am 12noon 1pm 3:30pm 9:30am 12noon 1pm 3:30pm 9:30am 12noon 1pm 3:30pm 9:30am 12noon 1pm 3:30pm 9:30am 12noon 1pm 3:30pm

Cost
$130 $130 $130 $130 $130 $130 $130 $130 $130 $130 $170 $170 $170 $170 $170 $170 $170 $170 $170 $170 $170 $170 $170 $170 $170 $170 $170 $170 $170 $170

Grades K-2 Super Heroes Unite! Seuss-O-Rama How Did That Happen! Where The Sidewalk Ends Musical Jam! Splat the Cat Under the Rainforest's Canopy Goosebumps! Riddle Me This Dancing Aesop's Fables Who Done It? Here Be Dragons Fractured Fairy Tales You Can Change the World! Pixies & Pirates Musical Jam! Grades 2-3 All Over the Map! The Geography of Movement Superheroes and Sidekicks Musical Jam! Adventures of the Immortals

CONTINUED ON NEXT PAGE

The Childrens Theatre Company

2400 Third Avenue S

Minneapolis, MN

55404

(fax) 612.874.8119

Select
Grades 2-3

Camp Title
Choose Your Own Adventure Sorcerer School The Bippolo Seed and Other Lost Stories by the Great Dr. Seuss Who Done It? Build A World (for the young visual artist who also loves theatre) Tales of Anansi the Spider A Tale of Dark & Grimm Musical Jam! Alice in Wonderland Myths and Magic The Miraculous Journey of Edward Tulane Super Heroes Unite! Goosebumps! It Came From Beneath the Bed! (Tales from the Bunnicula Series)

Dates
June 24-28 June 24-28 July 8-12 July 8-12 July 15-19 July 15-19 July 22-26 July 22-26 July 29-August 2 July 29-August 2 August 5-9 August 5-9 August 12-16 August 12-16

Times
9:30am 12noon 1pm 3:30pm 9:30am 12noon 1pm 3:30pm 9:30am 12noon 1pm 3:30pm 9:30am 12noon 1pm 3:30pm 9:30am 12noon 1pm 3:30pm 9:30am 12noon 1pm 3:30pm 9:30am 12noon 1pm 3:30pm

Cost
$170 $170 $170 $170 $170 $170 $170 $170 $170 $170 $170 $170 $170 $170

Grades 4-6 Fangtastic (My Sister the Vampire Series) Narnia Ho! Harriet the Spy Peter Pan (by audition only) Rocketship to Mars The Newsies Broadway Revue The Invention of Hugo Cabaret Sing Out on Stage Percy Jackson: Sea of Monster Artemis Fowl Broadway Rocks Circus of the Night Grades 5-8 Junior Intensive: Beauty and the Beast (by audition only) Grades 6-8 From Working to Wicked Shakespearean Death Scenes A Moment in the Spotlight The Maze Runner June 10-14 June 17-21 June 24-28 July 8-12 9am 4pm 9am 4pm 9am 4pm 9am 4pm $280 $280 $280 $280 July 15-August 4 9am 4pm $450 June 10-14 June 10-14 June 17-21 June 17-28 June 24-28 July 8-12 July 8-12 July 15-19 July 22-26 July 22-26 July 29-August 2 August 5-16 9am 12noon 1pm 4pm 9am 4pm 9am 4pm 9am 4pm 9am 4pm 9am 4pm 9am 4pm 9am 12noon 1pm 4pm 9am 4pm 9am 4pm $200 $200 $280 $430 $280 $280 $280 $280 $200 $200 $280 $430

CONTINUED ON NEXT PAGE

The Childrens Theatre Company

2400 Third Avenue S

Minneapolis, MN

55404

(fax) 612.874.8119

Select
Grades 6-8

Camp Title
OZ Revue LITTLE RED & Other Trips Through the Forest The Wizard's Way Musical Theatre Audition Workshop Audition Workshop

Dates
July 15-26 July 22-August 2 July 29-August 9 August 12-16 August 12-16 June 10-14 June 10-14 June 17-21 June 24-28 July 8-August 11 August 12-16 August 12-16 August 12-16

Times
9am 4pm 9am 4pm 9am 4pm 9am 12noon 1pm 4pm 9am 4pm 9am 4pm 9am 4pm 9am 4pm 10am 5pm 9am 12noon 1pm 4pm 11am 3pm

Cost
$430 $430 $430 $200 $200 $280 $280 $280 $280 $480 $200 $200 $200

Grades 7-12 Special Offering: Dance Intensive Grades 9-12 The Greatest Musical Scenes Ever Written The Katrina Project: Hell and High Water The Farce: Noises Off Senior Intensive: Hair (by audition only) Dance Bootcamp with Michael Matthew Ferrell Vocal Bootcamp with Joey Clark Improvisation (down and dirty) Bootcamp with Jen Scott

***Please make sure you have checked the Select box for every camp you are applying for.***

The Childrens Theatre Company

2400 Third Avenue S

Minneapolis, MN

55404

(fax) 612.874.8119

Student Information
Name: Sex (circle one): Current address: City: Home Phone: State: E-mail (optional): Zip Code: M F DOB: School Grade:

Number of sessions previously enrolled in TAT classes/camps:

1st Parent/Guardian Information

Name: E-mail: Current address: City: Occupation: Current employer: Select any that apply: Separated Single Parent Unable to Work Divorced Unemployed Deceased Work Phone: State: Zip Code: Phone:

2nd Parent/Guardian Information

Name: E-mail: Current address: City: Occupation: Current employer: Select any that apply: Separated Single Parent Unable to Work Divorced Unemployed Deceased Work Phone: State: Zip Code: Phone:

Other Dependent Children (Not including Student Enrolling in CTC Courses)

Name: Age: School/College: Tuition Paid by Parents: ___________________ Tuition Paid by Parents: ___________________ Tuition Paid by Parents: ___________________ Aid Received by Parents: ____________________ Aid Received by Parents: ____________________ Aid Received by Parents: ____________________

Name:

Age:

School/College:

Name:

Age:

School/College:

The Childrens Theatre Company

2400 Third Avenue S

Minneapolis, MN

55404

(fax) 612.874.8119

List other dependents, if any. Include any non-income generating family members that rely on your household for financial support. In case of dependents living outside of your home, please indicate approximate amount of financial assistance rendered each year.

____________________________________________________________ ____________________________________________________________ ____________________________________________________________

Total number of dependents (including child enrolling in CTC courses) Parents/guardians adjusted gross income (AGI) Teen students adjusted gross income (AGI) Adjusted Gross Income household total Your adjusted gross income can be found on: IRS Form 1040 IRS Form 1040A IRS Form 1040EZ Telefile line 37 line 47 and 52 line 11 K(2)

Please explain any special family circumstances such as divorce, unemployment, illness, etc.

____________________________________________________________ ____________________________________________________________ ____________________________________________________________

Are there any other funds that might be applied to the candidates education such as legacies, gifts, trust funds, educational insurance, alimony, other scholarships? Explain:

____________________________________________________________ ____________________________________________________________
Who assumes responsibility for the payment of tuition and other expenses?

The Childrens Theatre Company

2400 Third Avenue S

Minneapolis, MN

55404

(fax) 612.874.8119

The Childrens Theatre Company Education Department

Letter of Agreement
The Childrens Theatre Company Theatre Arts Training Program provides challenging, innovative, high quality arts education opportunities to students of every cultural heritage, ability and level of interest. Our goal is to help our students develop their imaginations, voices and bodies by teaching theatre skills that help them grow both as artists and as people. As a potential recipient of a scholarship, you must meet the following expectations. This will ensure that you receive the best possible experience and that the Childrens Theatre Company makes the best use of its limited financial resources.

Parent/Guardian Expectations
1) 2) 3) 4) You will ensure that the financial aid recipient attends all camps for which they are registered. You will ensure that the recipient is on time for all camps. You will ensure that the recipient brings appropriate materials/attire to all camps. You will meet established deadlines for tuition bills not covered by scholarship

Failure to meet the above expectations may result in the loss of aid and/or suspension of participation in camps. I certify that I have provided current, accurate and truthful information. I understand that, should I receive a scholarship I will be responsible for paying any tuition balance and applicable fees by the indicated deadlines. I have read the expectations outlining attendance and other guidelines. Parent/Guardian signature __________________________________ Date ______________

The Childrens Theatre Company

2400 Third Avenue S

Minneapolis, MN

55404

(fax) 612.874.8119

Mailing Checklist
Before mailing, have you included:

One (1) completed copy of Scholarship Request Form One (1) copy of the front page (or page showing AGI) of your most recent income tax return. One (1) copy of the Letter of Agreement signed by both the student and a parent/guardian.
Please do not include a camp registration form or any payment at this time. We will provide information on how to register with your scholarship determination.

Thank you for your interest in Theatre Arts Training camps. If you have any questions please contact Debra Baron at: dbaron@childrenstheatre.org or 612.879.5699

The Childrens Theatre Company

2400 Third Avenue S

Minneapolis, MN

55404

(fax) 612.874.8119