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MUSICAL THEATRE CONTESTANT APPLICATION 2019

National Society of Arts and Letters


Bloomington Chapter
Please Print Clearly

NAME_______________________________________________________________
Last First Middle

DATE OF BIRTH _________________________ (Age 18 to 29 on April 14, 2019)

ADDRESS___________________________________________ APT. ___________

CITY _______________________________ STATE_______ ZIP_______________

LOCAL PHONE ______________________ CELL PHONE ____________________

E-MAIL ______________________________________________________________

PERMANENT HOME ADDRESS _____________________________ APT._______

CITY ________________________________ STATE _______ ZIP _____________

STUDENT? YES ___ NO ____ SCHOOL ________________________________

YOUR TEACHER/ADVISOR_____________________________________________

DEGREE YOU ARE PURSUING _________________________________________


LIST THE SELECTIONS YOU WILL PERFORM

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

 Please make a copy of this application (both sides) for your files.
 Mail or deliver this application so it is received by
November 26, 2018 to:
Ray Fellman
Lee Norvelle Theatre and Drama Center
275 N. Jordan
Bloomington, IN 47405
 If there are any changes in the dates, times, or places of competition, you will
be contacted.
Questions?
Contact Ray Fellman at (812) 855-1908  or rfellman@indiana.edu

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