1. Name (as you would like it to appear in the program):

2. Roles, crew position(s), desgin position(s) for current show:

3. Year: Freshman    Sophomore    Junior   Senior   Other

4. Major: Theater      Other (specify major):

5. Are you...? (mark all that apply)

         Alpha Psi Omega      Theater Scholarship Recipient

6. Theater CNU production credits (list 3 shows - title/role/crew position/design position):

7. Community/professional production credits (list 3 shows - title/role/crew position/design position/ theater/company/city/state):

8. CNU Campus Activities (i.e. SGA, Motorsports, PLP, Vibes of the Vernacular, etc.):

9. Favorite Hobby (just one please):

10. Favorite book/play (title & author):

11. Ambition: Do you plan to pursue theater professionally and/or graduate school? If so, in what way and why? (i.e. I plan to take my career to Chicago, IL and build my professional background in technical design.) Explain.