First Name:
Last Name:

Grade: 9th  10th  11th  12th 

Address:
Street:
City:
State:		Zip:

Phone Number:

Email Address:

I am interested in the following (check all that apply):
Acting
Singing
Dance
Lighting
Stagecrew
Publicity
Set design
Set contruction
House crew
Costume
Make-up
Sound

List any and all experience that you might have:

I am also involved with (other activities):

Other questions: