Troupe #4996 Form
Please complete ALL information in order to be considered for Induction into the International Thespian Society Troupe #4996.
First Name *
Last Name *
Home Address *
Student Email Address *
Student Cell Phone Number *
Date of Birth (mm/dd/yyyy) *
MM
/
DD
/
YYYY
Graduation Year *
T-shirt Size *
Parent/Guardian Name *
Parent/Guardian Email *
Parent/Guardian Cell Phone *
Does the student want to receive scholarship, college, or other information by mail? *
Does the student want to receive scholarship, college, or other information by email? *
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