Application
Churchill
High School
8900
Newburgh Road
Livonia,
MI 48150
Date: _______________________
Name: _____________________________ Home Phone ( ) _________________
Address: ___________________________ City_____________ Zip__________
Present Grade Level__________________ Date of Birth_____________________
Parent/Guardian Name________________ Work Phone ( ) _________________
Parent/Guardian Address___________________________________________________
(If different)
Present School of Enrollment____________________________________________
What high school are you scheduled to attend? Churchill Franklin Stevenson
(Please circle one)
Area of
Specialization/Interest
(Please check one)
Dance ___
Acting ____
Technical Theatre ___
Music: Vocal ___
Describe
briefly your background in your area of specialization/interest
_____________________________________________________________________________________
_____________________________________________________________________________________
Statement of Intent (Please write a brief paragraph concerning your goals)
_____________________________________________________________________________________
_____________________________________________________________________________________
Recommendations: Please attach one letter of recommendation from present or former teachers (public or private) within your area of specialization.
Statement of Commitment:
It is understood that participants in the CAPA Program must be willing to
participate in rehearsals, performances, and/or exhibits that serve as important
culminating experiences of class work. I
make this commitment:
Student Signature________________________________________
NOTE: You will be contacted by CAPA staff for interview/audition.