The 2012 Vincent Legacy Scholarship Application

The 2012 Vincent Legacy Scholarship Application A financial need based scholarship for sixth, seventh and eighth grade focused on ethnically diverse youth

The application deadline is Monday, March 26, 2012. Application Guidelines: The Vincent Legacy Scholarship Fund is a scholarship based on financial need and was created for sixth, seventh and eighth grade ethnically diverse youth exhibiting a passionate interest and strong ability in the performing arts and who express his/her interest in meeting certain criteria. Students must have the strong desire and motivation to further refine and improve their skills through professional instruction. They must maintain an academic achievement level equal or greater than a “B” (3.0) grade level, attend school regularly with no unexcused absences, and demonstrate an interest in community service. I. Information to be submitted by the applicant: On a separate piece of paper, please write a request for consideration addressing the following (You may complete this with assistance from your teacher, parent or guardian, if necessary.):  Do you have previous acting, singing or dancing experience or training? Please explain.  What other special skills or talents would you like us to know about (foreign languages, juggling, painting or drawing, musical instruments, etc.)?  Do you participate in community service? If yes, please provide a contact name and phone number at the agency you volunteered for and describe the community service(s) you’ve performed.  Is there a particular area of community service that interests you (i.e., health care, arts, elderly, childcare, etc.)?  Why do you deserve to be selected to receive the Vincent Legacy Scholarship? II. Information to be submitted in support of the applicant:  Letter of recommendation from the applicant’s teacher  Letter of recommendation from the student’s current performing arts instructor(s) or coach(s), if any  Letter of support and encouragement from parent(s) or guardian(s)  Official record of current year grades and attendance report from the applicant’s school (for this full school year only)

Return completed applications and support materials to: Starlight Theatre Education Department Attn: Vincent Legacy Scholarship Fund 4600 Starlight Road Kansas City, MO 64132 Fax: (816) 361-6398 All applicants who submit completed applications will be contacted (by e-mail) to verify receipt of their materials. To continue in the selection process, applicants must be invited to audition. For those selected applicants, auditions will take place between 10:00 a.m. and 1:00 p.m. on Saturday, April 14, 2012. A specific time will be set and audition expectations will be provided when the applicant is notified that he/she is being invited to audition. No other time or day will be made available for auditions. Is the applicant available for an audition on April 14, 2012 if asked to continue in the process? yes no I. Applicant Information:

Applicant’s Name (Last, First, Middle Initial):

Parent/Guardian #1 Name:______Parent/Guardian#2 Name:______

Parent/Guardian #1 Cell:______Parent/Guardian #2 Cell:______

Home Phone: Alternate Phone Number:

Home Address:

City: State: Zip:

Parent/Guardian #1 E-Mail:______Parent/Guardian #2 E-Mail:______

Grade to be completed by June: Age: Gender: Male Female Birth Date:

Name of Current School:

Address of School:

City: State: Zip:

Recommending Teacher’s Name:

Daytime Phone Number of Teacher:

II. Acting/Singing/Dance Training Information:

In what area/s of the performing arts are you most interested? Acting Singing Dancing

Have you had training in any of the following areas?

Acting Yes No If yes, for how long have you trained? ______Singing Yes No If yes, for how long have you trained? ______Dancing Yes No If yes, for how long have you trained? ______

If you have had acting training, where did you train? ______

List any acting experience that you have (school plays, church plays, etc…) ______

If you have had dance training, where did you train? ______

For what type/s of dance did you train? (ballet, jazz, tap, hip hop, etc…)

If you have trained in singing, what is the name of your instructor/training program? ______

Please list any prior singing experience (choir, school musicals, etc…):

Are there any other special or unique skills you would like us to know about?

NOTE: Demonstration of financial need is a requirement for qualification for the Vincent Legacy Scholarship. You may be asked to provide a copy of your 2011 federal tax return.

III. Income Information from 2011

1. Annual income of male parent or guardian (wages, salaries, tips) $

2. Annual income of female parent or guardian (wages, salaries, tips) $

3. Other taxable income (specify: pensions, capital gains, etc.): $

4. Annual alimony or child support $

5. Annual Social Security benefits $

6. Other non-taxable income (specify source): $

Total Income (add lines 1-6) TOTAL: $

IV. Additional Financial Information

Monthly rent or mortgage payment: $

Average monthly bills: $

Total number of dependent children in household:

Names and ages of children:

Does the applicant qualify for free or reduced lunch at his/her school? Yes No

Do you receive financial assistance from any outside source? If yes, please explain:

Is there anything else you would like us to consider regarding your financial situation?

______

For the purpose of this scholarship, an “ethnically diverse youth” is defined as:

African-American Hispanic-American Native-American Asian-Pacific American Asian-Indian American

Does the applicant fit the definition of an ethnically diverse youth as listed above? Yes No The Vincent Legacy Scholarship is not solely considered a financial award. The winner of the scholarship joins a group of talented former winners as well as adult mentors whose mission is to guide and encourage the scholars as they advance in their performing arts training while maturing into adulthood. As part of this selected group, scholars are expected to contribute to this mentoring process by doing the following:

 Participating in social gatherings with other Vincent Legacy winners and adult mentors at least once a year (at the holidays) and, for current and last year’s winners, during the summer on Vincent Legacy Scholarship winner announcement night on the Starlight Theatre stage  Making themselves available for public relations appearances and performances on behalf of the scholarship program  Remaining in frequent and direct contact with the adult mentors involved with the program including responding to phone calls and e-mails in a timely manner  Providing yearly progress information regarding his/her performing arts training as well as personal growth through the prior year

“I certify that the facts contained herein are true and complete to the best of my knowledge and understand that, if granted the scholarship, falsified statements on this application shall be grounds for removal of scholarship monies. I have also read and understand that as a winner of the scholarship I will become part of a mentoring program and agree to the above outlined requirements of that program.”

Date: ______

Applicant Signature: ______

Parent/Guardian Signature: ______

The deadline for application materials to arrive at Starlight is March 26, 2012. Please double-check that the following are included with the completed application:  Letter of request by the student to be considered for the scholarship  Letter of recommendation from the applicant’s teacher  Letter of recommendation from the applicant’s current performing arts instructor(s) or coach(s), if any  Letter of support and encouragement from parent(s) or guardian(s)  Official record of current year grades and attendance report from the applicant’s school (for this full school year only) NOTE: All applicants will be notified when application materials have been received. We will advise if any materials are missing. If the missing materials are not submitted by the deadline, the application will not be considered.

For questions about the Vincent Legacy Scholarship, contact the following:

Amy Reinert, Director of Education and Outreach, 816-997-1112 or [email protected]

Andy Pierce, Education Coordinator, 816-997-1134 or [email protected]