Name *

First Name

Last Name

Phone

(###)

###

####

Permanent Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Current Address (If attending school):

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Birthdate *

Share your birthday with us so we can confirm your eligibility.

MM

DD

YYYY

Will you need housing in Houston?

Yes

No

Check all areas of interest *

Scenic

Scenic Painting

Lighting

Sound

Properties

Costumes

Theatre Administration

Marketing

Development

Box Office

Front of House

Theatre Education

Reference 1 Phone Number:

(###)

###

####

Reference 2 Phone Number:

(###)

###

####