Scholarship Application Form
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Full legal name of applicant
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Date of birth
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Phone number
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Email
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Mailing address
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Name of high school attended
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Graduation date or anticipated graduation date
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Name of post secondary institution
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Name of program or major
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Terms or of
Have you been accepted into this program?
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Yes
No
What program year will you be attending?
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First year
Second year
Third year
Fourth year
Other (please specify below)
If "other" selected for program year, please specify
Terms and conditions
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Applicant (if 18 years or older)
Parent or guardian (if applicant under 18 years). Please provide parent or guardian name below.
In consideration of my application to the Dave Symington Fine Arts Memorial Scholarship, I hereby release and hold harmless Stage North Association, its agents and representatives from any and all responsibility or liability for damages of any kind suffered in any manner whatsoever, including as a result of any breach of the representations and warranties set out above. By checking the box below, I, the assignor, agree to all Terms and Conditions of this agreement and I acknowledge that failure to read the Terms and Conditions will still result in a binding agreement.
Parent or guardian name (if applicant under 18 years)
First
Last
The following MUST be submitted with your application.
An artistic statement or vision that represents your career or academic goals in any appropriate medium
A letter of recommendation from your performing arts/visual arts teacher or instructor
The following may be submitted at the time of application and will be required in order to receive the award.*
Proof of high school graduation
Proof of fine arts credits at high school level
Proof of enrollment in an accredited post–secondary institution**
* If you are selected for an award and these have not yet been submitted, you must submit them in order to claim the award. You have one year from your submission date to provide these documents and claim the award.
** Either majoring in fine or performing arts, or enrolled in a dedicated fine or performing arts program.
Upload artistic statement or vision (required)
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Upload letter of recommendation from performing arts/visual arts teacher or instructor (required)
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Upload proof of high school graduation
Upload proof of fine arts credits at high school level
Upload proof of enrollment in an accredited post-secondary institution
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