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

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Today's Date:

Name:(required)

Email: (required)

Postal Address:

City:

State: Zip: (required)

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 $: