Firebird Scholarship Application
Please complete this form to apply for a partial or full scholarship for one of our programs. This form goes directly and confidentially to our Scholarship Coordinator.
Student's Name *
Your answer
Student's Age *
Your answer
What type of program are you applying for? *
Required
Name of Workshop Program/Show
Your answer
Parent/Guardian Name *
Your answer
Address
Your answer
Email Address *
Your answer
Home Phone
Your answer
Cell/Work Phone
Your answer
Number of people in household *
Your answer
Number who are dependents *
Your answer
Annual Household AGI (line #37 form 1040) OR income from last 90 days *
Your answer
Does your student receive free or reduced lunch at school *
Briefly describe extenuating circumstances (illness, unemployment, single parent etc) *
Your answer
Type of scholarship for which you are applying: *
If partial, please fill in amount under "Other"
Required
Do you certify that the above information is true and correct for all household members? *
Required
Thank you
The Scholarship Coordinator will contact you. Firebird Theatre reserves the right to terminate a scholarship at any time for false information or inappropriate behavior
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