Phoenix Theatre Summer Camp Scholarship Application
Summer 2015
Dear Campers & Parents:
Through the generosity of our donors, Phoenix Theatre is pleased to offer scholarships for campers
with challenging economic needs. Since the availability of scholarship money is extremely limited and
will cover only a portion of the cost to attend Phoenix Theatre Summer Camps, we have implemented
a new application process to ensure that available funds are distributed as fairly as possible. If you feel
you need scholarship assistance, please carefully review and complete the following application to be
considered for a scholarship (incomplete applications cannot be considered). Please note that
scholarship awards may only be applied to the direct cost of camp attendance and may not be applied
to pre or post camps, t-shirts or other products and/or services that may be offered.
Steps:
1. Campers: Complete page one by writing or typing your answers in the spaces provided.
2. Parents/Guardians: Complete pages two and three by writing or typing your answers in the spaces
provided.
3. Sign, date and return the 3 pages to Phoenix Theatre by April 15, 2015:
Sydney Kreuzmann
Phoenix Theatre
100 E. McDowell Rd
Phoenix, AZ 85004
Email/Scan:
[email protected]
Fax:
602-889-6323
Today’s Date____________________
Camper Name________________________________________ Date of Birth________________
School Currently Attending_____________________________ Age on first day of camp_______
Current Grade Level_______________
1. a) Have you attended a Phoenix Theatre Summer Camp before?
______________________________________________________________________________________
1. b) What did you learn or discover at this camp? (If you answered ‘no’ to question 1(a) please skip to
question number 2)
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2. Why do you want to attend Phoenix Theatre Summer Camp this year?
______________________________________________________________________________________
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Camper Signature: _______________________________
Date: ___________________
Page 1 of 3
Parent/Guardian Name______________________________________________________________
(please print)
Currently Employed?__________ Relationship to Camper________________________________
Spouse Name (if applicable)___________________________________________________________
Currently Employed?__________ Relationship to Camper________________________________
Primary Address___________________________________________________________________
Street Address
Apt #
City_________________________ State_______
Zip Code___________
Phone Number____________________________
Alt Phone Number__________________
Email____________________________________
Alt Email__________________________
Annual Household Income: (please check one)
Total Number Living in Household: _____________
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$0.00 - $19,999
$20,000 - $29,999
$30,000 – $39,999
$40,000 - $49,999
$50,000 - $74,999
$75,000 +
Why are you requesting a scholarship for Phoenix Theatre Summer Camp?
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Please list the dates your dependent(s) will be attending:
_____________________________________________________________________________________
_____________________________________________________________________________________
What kind of experience are you hoping will be provided to your child through Phoenix Theatre
Summer Camp?
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
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Page 2 of 3
How would this scholarship benefit your camper and your family?
______________________________________________________________________________________
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How did you hear about Phoenix Theatre Summer Camps?
______________________________________________________________________________________
______________________________________________________________________________________
How may we contact you regarding your Summer Camp Scholarship?
______________________________________________________________________________________
______________________________________________________________________________________
Anything else you would like to tell us?
______________________________________________________________________________________
______________________________________________________________________________________
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How much would be a feasible (total) contribution from you? $_______________________________
I have completed all applicable information requested accurately and to the best of my ability. I understand that completion of
this application does not automatically qualify me for assistance. Requests are subject to review based on need and availability
of scholarship funds.
Parent(s) Signature: ______________________________________
Date: _____________
-----------------------------------------------------------------------------------------------------------------------------------------------------------------------Please return application to Phoenix Theatre no later than April 15, 2015.
Email to: [email protected]
Fax to: 602-889-6323
Mail to: 100 E. McDowell Rd, Phoenix AZ 85004
You will receive notification if you are awarded scholarship money by May 1, 2015. Thank you for your patience.
Please direct all questions to Sydney Kreuzmann at 602-889-5293 or [email protected].
FOR OFFICE USE ONLY:
Date Received ____________________
Page 3 of 3
Scholarship Amount Awarded __________________________________________
Acceptance? ________________________________________________________