23-24 JumpStart Theatre Application

School Name(Required)

School Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Contact Name(Required)

Phone

Email(Required)

Principal Name

Assistant Principal Name

Number of Students Enrolled

Number of Teachers

Number of Arts Teachers

Number of Staff

Does the school have an auditorium (or similar space)?

Which of the following does the auditorium (or similar space) have? Check all that apply.

Theatrical lighting system

Sound system

Permanent seats

Administrator 1

Teacher 1 (Director/Main Contact)

Teacher 2 (Music Director)

Teacher 3 (Choreographer)

Parent Coordinator (if known)

Do you offer any after-school programming in your school?

Please explain the programming:

Do you currently offer any arts programming in your school?

Please explain the programming:

Describe how you would schedule this program to fit into your school's schedule:

How do you hope this program will affect your in-school community?

How do you hope this program can affect the community around your school?