Basic Information Form

The following information form must be completed by all applicants.

When filling out the following form, please use the TAB key to move from one entry field from the next. In some browsers, hitting the ENTER or RETURN key will submit your form.

Once you submit your form, you will have the chance to review the information you typed to confirm that it is correct.

Last Name:

First Name:        MI:

Street Address:

City:        State/Province:

Zip:

Country (if not USA):

Age:
Daytime Phone:

Evening Phone:

Service or Beeper:

E-Mail Address:

Male        Female

Area of Interest:
Ph.D. Acting Dance Theatre Directing Costume Design Lighting Design Playwrighting Scenic Design Sound Design Stage Management

What prompted you to apply for our program?

One of my undergraduate teachers recommended UCSD
Direct communication with faculty and/or staff at UCSD Department of Theatre and Dance
An advertisement in American Theatre magazine
An advertisement in Dramatics magazine
An advertisement in Stage Directions magazine
An advertisement in Entertainment Design
UCSD's reputation in theatre
Other (please specify)

Recommenders:
1) Name:       Phone:

2) Name:       Phone:

3) Name:       Phone:

Post Secondary Information:
School:

City/State/Country:

Date of Graduation:       Degree Attained:

Please list other institutions to which you intend to apply:

Financial Aid:

The following section has no bearing on your acceptance into UCSD or the Professional Theatre Training Program. A number of special scholarships, grants, and financial awards are available at UCSD. In order that we may assist you in applying for a financial aid package, please check all that apply:

Resident of and/or high school graduate from Nevada City or Grass Valley, CA.
Graduate of Benecia High School of California.
Hard of hearing of adventitiously deaf.
One parent who is or was a regular member of the U.S. Navy or Marine Corps.
A direct descendant of a U.S. World War I veteran.
Jewish with financial need.

Ethnicity Code: A. African American B. Japanese / Japanese American C. American Indian or Alaska Native D. Other (specify below) E. Chicano / Mexican American / Puerto Rican F. White L. Philipino / Filipino M. Polynesian/Micronesian R. East Indian / Pakistani V. Vietnamese X. Korean / Korean American Y. Thai / Other Asian 2. Chinese / Chinese American 5. Latino / Latino American

If you selected "D. Other", please specify here:

If you are NOT applying in ACTING, submit your form now.

ACTORS: Please enter your email address below, and then continue to the next section

Enter your e-mail address here to receive a confirmation of your audition date and time:

Continue to the next section.

ACTORS ONLY:

Audition Request Form:

These dates are for 2010 auditions only.

Please indicate your first choice for audition site and date:
New York: January 21 New York: January 22 New York: January 23 New York: January 24 Chicago: February 02 Chicago: February 03 San Francisco: February 06 San Francisco: February 07 San Diego: February 12

Please indicate your second choice for audition site and date:
New York: January 21 New York: January 22 New York: January 23 New York: January 24 Chicago: February 02 Chicago: February 03 San Francisco: February 06 San Francisco: February 07 San Diego: February 12