Application Form for The Centenary Young Performers' Workshop |
TO
ENROLL: PLEASE PRINT
THIS FORM, COMPLETE IT, AND RETURN IT WITH A HEADSHOT OR SNAP
SHOT, as well as any other information you deem necessary.Video
tapes are welcome. Auditions and/or interviews with Michael Blevins, or his appointee, are required. The Centenary Young Performers' Workshop may be contacted at: Centneary Performing Arts Guild, 400 Jefferson Street, Hacketstown, NJ 07840 (908) 979-0900 E-Mail Rustc@centenarystageco.org |
Student Name
Social Security Number |
Address |
City |
State |
Zip |
Home Phone |
Work Phone |
E-mail |
Age Date
of Birth / / |
Weight Height |
Hair Color |
Instruction |
Song
|
Dance
|
Instruments
|
Theatre Training
|
What is your objective? |
Parent/Guardian
Name |
Address |
City
|
State |
Zip |
Home Phone |
Work Phone |
E-mail |
Please provide two character
references |
Name |
Address |
City
|
State |
Zip |
Home Phone |
Work Phone |
E-mail |
Name |
Address |
City
|
State |
Zip |
Home Phone |
Work Phone |
E-mail |
TheCentenary Young Performers' Workshop is a not for profit educational
institution that admits students of any race, creed, sex, national,
or ethnic origin. The CYPWis a division of the Centenary Performing Arts Guild that houses the Centenary Stage Company a professional Equity theatre in residence at Centenary College, Hackettstown, New Jersey.
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