2018 WEST Tom Empey Memorial Scholarship
Fill out this form for the WEST Tom Empey Memorial Scholarship.
Email address *
Last Name *
First Name *
Date of Graduation *
Age *
Home mailing address *
City and State *
ZIP Code *
Home Phone *
High School Drama Teacher *
High School *
High School Phone Number *
School Mailing Address *
School City *
School ZIP Code *
What additional activities are you involved in? (i.e.: Speech and Debate, Clubs, Sports, Student Government, etc.) *
Intended Major *
Intended Minor *
Cumulative Grade Point Average (4.0 scale) *
Total Senior Class Enrollment *
Class Rank *
SAT or ACT score (make sure to label each) *
List Theatrical Experience. Follow this order: Production, Position/Role, Producing Organization. Separate entries with a semi-colon (;) *
The WEST Tom Empey Memorial Scholarship is for students who want to pursue their education. How has theatre impacted your life, and how will you use your experience in theatre to impact those around you? *
GOALS: Write concisely on your aspirations and plans for college and your future. *
RELATED WORK: List all the theatre related courses and extra-curricular theatrical activities. *
Submit two letters of recommendation. Only one letter may come from your theatre teacher or coach. *
Additional info: (If there is any additional information you would like to provide, please put that here.)
A copy of your responses will be emailed to the address you provided.
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