EAST BAY CENTER FOR THE PERFORMING ARTS - Young Artist Diploma Scholarship Nomination Form

Nominations and applications accepted through April 30, 2019
---Limited space available. Early applications strongly recommended---
Nominator Information
Full Name & address of Organization/School Representative
Nominator Full Name
Your answer
Nominator Work Address
Your answer
Nominator Phone Number
Your answer
Nominator email
Your answer
Nominee Information
Name of student being nominated as a Diploma Artist
Nominee Full Name
Your answer
Nominee Background: (Briefly describe the performing arts background and/or characteristics as to why this student would make a good candidate to receive a Diploma Artist scholarship from East Bay Center)
Your answer
Nominee Parent Information
Parent Full Name
Your answer
Parent Phone
Your answer
Parent Email
Your answer
If you have any questions, please contact:
Kwesi Anku, Associate Director of Student Development & Training
Kwesi@eastbaycenter.org, 510-323-4495
Submit
Never submit passwords through Google Forms.
This form was created inside of East Bay Center for the Performing Arts. Report Abuse - Terms of Service