Black Box Theatre Company

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    Please include as much information in your application as possible. The more the Scholarship Committee understands your personal situation, the better educated they are to make a final decision.

    Have you completed a full scholarship application, including all financial information and references, within the last 12 months?*

    Are you a high school student applying independently due to lack of financial support from a parent or guardian?*

    Parent Information

    Primary Parent Information

    Add Secondary Parent Information?

    Secondary Parent Information

    Dependent Information

    Dependent 1

    Dependent 2

    Dependent 3

    Dependent 4

    Dependent 5

    Dependent 6

    Applicant Information

    Applicant 1

    Applicant 2

    Applicant 3

    Applicant 4

    Applicant 5

    Applicant 6

    Reference Information

    A minimum of two references is required. Please include friends, employers, or clergy that you would give as references.

    Reference 1 Information

    Reference 2 Information

    Black Box & You

    Do you have any personal connections to Black Box, such as a family member who teaches or serves on the Board of Directors?

    Financial Information

    In your most recent tax filing, did you file tax form 1040?

    Monthly Expenses

    The following sections show a general breakdown of your monthly expenses.

    If a particular section is not applicable, just put NA.

    Financial Documents

    We require a copy of your latest tax form AND two most recent pay stubs in order for your scholarship application to be complete.

    Applicants that have not given this information will not be considered by the Black Box Scholarship Committee.

    Prior to submitting these documents, please obscure any tax id numbers.

    You may choose one of the following three methods to submit this information:

    1. Upload documents using this form (Preferred)

    2. Email documents to Black Box President

    3. Arrange a time with Kelley Johnson to drop off paper copies at Black Box

    These are the only three options for submission and must be completed 10 days before the start date of the class or show.

    Additional Comments

    Acknowledgements

    By checking the box you are agreeing to the following:

    • We (I) understand that financial scholarships are awarded based on application, availability, and need. Financial scholarships are partial scholarships, in that, a portion of the tuition fees are paid by the scholarship.

    • We (I) understand that we are responsible for the remaining registration fee.

    • We (I) understand that we may be called upon to volunteer during theatre functions, using our time and talents.

    • We (I) will abide by tuition policies as set forth by Black Box Theatre.


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