Scholarship Application Form
IMPORTANT-This application will not be processed unless you meet all of these eligibility requirements:
All candidates for scholarships must be :
• North American citizens
• Members of UNIMA-USA
• Over the age of 18
• Second level puppeteers (ie. some experience and/or university degree)
• This scholarship is only for applying for aid to study with a recognized puppetry professional or professional program outside of North America

---

Today's Date:
Name(s):
Email Address:
Postal Address:
City:
State:
Zip:
Day Phone:
Night Phone:
Fax:
Date of Birth:
Place of Birth:
Nationality:
List all Languages Spoken and Level of Fluency:
Program You Wish to Participate In (International Only):
Dates of Program:
Scholarship Amount Requested:	Partial Total
Amount $:

form creator