Name of Student *

First Name

Last Name

Is your child a new or returning Playhouse Arts Academy student? *

New

Returning

Have you previously applied for Arts Academy scholarship funding? *

Yes

No

Please select the Camp(s) you are seeking scholarship for *

Legally Blonde, Jr

Matilda, Jr

Name of Primary Contact *

First Name

Last Name

Relationship to Student *

Parent

Grandparent

Guardian

Caregiver

Other

Primary Contact Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Primary Contact Phone *

(###)

###

####

Primary Contact Cell

(###)

###

####

Family Status *

Co-Parent

Single Parent

Foster Parent

Employment Status *

Full-time

Part-time

Currently Seeking

Retired

Unable to Work

Scholarship Contribution you are seeking *

25%

50%

75%

100%

By submitting this application, I certify all of the information in this application is true and accurate to the best of my knowledge. I understand I may be contacted to provide additional documentation in support of the above. I understand submitting this application does not guarantee Ogunquit Playhouse Arts Academy is obligated to grant any scholarship assistance. *

By checking this box, I certify I have read and agree to the above statement