TSA/GIA Scholarship Application

Department of Theatre Arts
Eastern Illinois University

Date / MM / DD YYYY
Semester I'm applying for a scholarship Fall Semester Spring Semester
Enter one or more area(s), in order of preference, you'd like to be considered for a Talented Student scholarship.

First area of preference:
Second area of preference (if desired):
Third area of preference (if desired):
I am a declared Theatre Major Minor
Enter your Major/Minor emphasis: Teacher Certification Performance Technical/Design Directing Generalist History/Literature Undecided
Name First Last
E Number
Date of Birth / MM / DD YYYY
Male Female
Home Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Phone - (###) - ### ####
Cell Phone - (###) - ### ####
Applicant E-mail
Alternate Email
EDUCATION BACKGROUND

GPA on a 4.0 scale (contact Damita Lewis at (217)581-5918 if not on a 4.0 scale)
Date of GPA Record / MM / DD YYYY
College or High School attended, list last attended first
Location
Major
Degree or Diploma?
Years in attendance
College or High School attended, list last attended first
Years in attendance
Degree or Diploma?

Indicate if you received a degree or diploma. If none was received, list highest level of education.
Major
Location
List any training or experience you have had in the following 5 areas or submit a resume' below.

1. Vocal (performing or coaching)
2. Dance (performing or choreographing)
3. Directing
4. Acting
5. Muscial instrument(s) played
Upload your resume'
Upload your headshot
THEATRE EXPERIENCE - List the name and address of theatres you have worked, most recent first:

WORK EXPERIENCE #1:
WORK EXPERIENCE #2:
WORK EXPERIENCE #3:
WORK EXPERIENCE #4:
TECHNICAL EXPERIENCE - Set design, costuming, lighting, etc. List the title of the play, position or responsibility, and the name of the theatre from the Work Experience list you provided above, most recent first (make sure to include your resume' if more than 6 experiences):

TECHNICAL EXPERIENCE #1
TECHNICAL EXPERIENCE #2:
TECHNICAL EXPERIENCE #3:
TECHNICAL EXPERIENCE #4:
TECHNICAL EXPERIENCE #5:
TECHNICAL EXPERIENCE #6:
ACTING EXPERIENCE - List the title of the play or musical, name of character and name of the theatre from the Work Experience list you provided above, most recent first (make sure to include your resume' if more than 6 experiences):

ACTING EXPERIENCE #1:
ACTING EXPERIENCE #2:
ACTING EXPERIENCE #3:
ACTING EXPERIENCE #4:
ACTING EXPERIENCE #5:
ACTING EXPERIENCE #6:
REFERENCES - List below the name, e-mail, and phone number of three people you have asked to send letters of reference on your behalf:
Reference #1 Name: * First Last
Ref. #1 Email
Phone - (###) - ### ####
Reference #2 Name: * First Last
Ref. #2 Email
Phone - (###) - ### ####
Reference #3 Name: * First Last
Ref. #3 Email
Phone - (###) - ### ####
COMMENTS - You may use this space for any comments that you think might be helpful in evaluating this application, e.g. "special skills" or "talents."
Thank you for completing this application, once you hit SUBMIT the application will be e-mailed to the EIU Theatre Dept. You will be contacted after the application deadline date to arrange an interview/audition date and time.
Revised for web 10/18/11

TSA/GIA Scholarship Application

TSA/GIA Scholarship Application

REFERENCES - List below the name, e-mail, and phone number of three people you have asked to send letters of reference on your behalf:

Thank you for completing this application, once you hit SUBMIT the application will be e-mailed to the EIU Theatre Dept. You will be contacted after the application deadline date to arrange an interview/audition date and time.

Revised for web 10/18/11