Section 1 of 1
VanPlay Stage Society Bursary Application Form
Email
Email
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File upload
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Date
Time
Number
Text
Length
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Contains
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Email
URL
Answer key
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Child's Name:
Child's Name:
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Paragraph
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Multiple choice grid
Checkbox grid
Date
Time
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Child's Birthday:
Child's Birthday:
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Short answer
Paragraph
Multiple choice
Checkboxes
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File upload
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Time
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Country of Residence:
Country of Residence:
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Short answer
Paragraph
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Checkboxes
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File upload
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Date
Time
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Country of Citizenship:
Country of Citizenship:
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Short answer
Paragraph
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Time
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Parent/Guardian Name (1):
Parent/Guardian Name (1):
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Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
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Multiple choice grid
Checkbox grid
Date
Time
Answer key
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Gross Annual Income:
Gross Annual Income:
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Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
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Parent/Guardian Name (2):
Parent/Guardian Name (2):
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Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
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Gross Annual Income:
Gross Annual Income:
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Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
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Total Gross Annual Family Income:
Total Gross Annual Family Income:
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Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
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# of persons in household:
# of persons in household:
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
1
2
3
4
5
6
7
Other:
Add option
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Answer key
(0 points)
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Mailing Address:
Mailing Address:
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
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City:
City:
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Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
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Prov/State:
Prov/State:
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Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
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Rating
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Checkbox grid
Date
Time
Answer key
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Postal/ Zip Code:
Postal/ Zip Code:
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Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
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Phone Number:
Phone Number:
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
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E‐Mail:
E‐Mail:
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
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Student SIN or ITN:
Student SIN or ITN:
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
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Student Pronouns:
Student Pronouns:
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Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
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Multiple choice grid
Checkbox grid
Date
Time
She/her
He/him
They/them
Other:
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Answer key
(0 points)
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Which Performing Arts Program are you applying for funding to take part in?
Which Performing Arts Program are you applying for funding to take part in?
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Short answer
Paragraph
Multiple choice
Checkboxes
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File upload
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Multiple choice grid
Checkbox grid
Date
Time
Answer key
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I certify that the information given is true and accurate.
Signature of Parent/Guardian or Participant (if 19 yrs or older) & date:
I certify that the information given is true and accurate.
Signature of Parent/Guardian or Participant (if 19 yrs or older) & date:
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
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