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2021 Las Casas Production Assistant Internship Program Application
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First Name:
*
Your answer
Last Name:
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Your answer
Address:
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Your answer
City:
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Your answer
State:
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Your answer
Zip Code:
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Your answer
Cell Phone Number:
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Your answer
Personal (Not School) Email Address:
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Your answer
How did you hear about this opportunity?
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Choose
Teacher
Classroom Visit
Facebook
Instagram
Behind the Scenes
Google search
Camp Broadway
Other
U.S.A./Naturalized Citizen?
*
Choose
Yes
No
Texas Resident?
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Choose
Yes
No
Ethnicity:
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Choose
White
Hispanic or Latino
Black or African American
Native American or American Indian
Asian/Pacific Islander
Other
Prefer Not To Answer
Annual Family Income Range (Note: This information in no way affects scoring or outcomes; it will remain anonymous and only used internally for program reporting.)
*
Less than $50,000
$50,000 - $99,999
$100,000 - $149,999
$150,000 - $199,999
$200,000+
Date of Birth:
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MM
/
DD
/
YYYY
Sex:
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Female
Male
Other
Prefer Not To Answer
Preferred Pronouns:
*
She/Her/Hers
He/Him/His
They/Them/Theirs
Parent's Name(s):
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Your answer
Parent's Cell Phone Number:
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Your answer
Parent's Email Address:
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Your answer
School:
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Your answer
Grade Level:
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Choose
9th
10th
11th
12th
Theatre Teacher's Name:
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Your answer
Theatre Teacher's Email:
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Your answer
Theatre Teacher's Phone Number:
*
Your answer
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