Memorial Scholarship Application

Memorial Scholarship

National Application

RETURN NO LATER THAN July 10, 2024

Applicants must be registered in Dancewerks National 4-Day Main Camp
In the event there are less than 10 (ten) applicants, we reserve the right to cancel and refund all monies
Applications, application fee, essays and photos will not be returned
By signing this application, the applicant and the applicant’s guardian accept the rules and regulations of the dance scholarship and agree to abide by and accept the same
Signed Release Form from Main Camp applies to this event.

TO REGISTER:

Complete the on-line form below and submit.
Mail the following information to: Dancewerks 616 South Street Barrington IL. 60010

APPLICANT NAME(Required)

ADDRESS(Required)

Street Address City State Zip

TELEPHONE(Required)

EMAIL(Required)

(primary means of communication / please supply accurate email info.)

AGE(Required)

BIRTHDATE(Required)

TEACHERS NAME(Required)

STUDIO NAME(Required)

SIGNATURE OF APPLICANT(Required)

Application Fee

Price:

Total

Credit Card(Required)

Cardholder Name

Card Details