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Adler Youth & Summer Shakes Application, Part 1
Arts Justice Division's Adler Youth Program
* Indicates required question
Email
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Your email
Full Name
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Your answer
What school do you attend?
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Your answer
I'm interested in:
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Adler Youth
Summer Shakespeare
Both
Required
Age
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Your answer
Date of Birth
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MM
/
DD
/
YYYY
Grade Attending
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9th
10th
11th
12th
Address, Apt #, City, Zip Code
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Your answer
Cell Phone Number
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Your answer
Home Phone Number
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Your answer
Parent/Guardian's Name
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Your answer
Parent/Guardian's Email Address
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Your answer
Do you take any medication(s) we should know about?
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Your answer
Do you have any injuries we should know about?
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Your answer
Who should we contact in case of an emergency?
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Your answer
Phone Number
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Your answer
Relationship to You
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Your answer
Does your school offer theater or drama?
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Yes
No
This program aims to reach students who do not have the means or the opportunity to study acting. Why do you need this program?
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Your answer
Actor training is very demanding. You will have to read, study, and do exercises at home to prepare for class. Will you make time to do that?
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Yes
No
Students are expected to be on time and attend every class, no matter what. Will you be committed through the whole program?
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Yes
No
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