Registration

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Please read the information below in order to be considered for the 2019-2021 Male Scholarship Program at Central Pennsylvania Youth Ballet.

RETURNING applicants must login to their Family Portal using the red link above. Please contact CPYB at 717.245.1190 if you need assistance with your username and password. Again, one application per student only.

(STEP 1) Complete and submit the following application in its entirety. ALL FIELDS ARE REQUIRED.
If you are under the age of 18, enter parent/guardian name, phone, e-mail, and mailing address in the contact field. Students must enter all required information in the "add student" option.

(STEP 2) Submit your audition video by the deadline of Wednesday, May 15, 2019. Video should be uploaded to Youtube or Vimeo. Once uploaded, submit the video URL link to mensprogram@cpyb.org.

Event:

Start Date/Time:

End Date/Time:

Fee per Student:

Room:

* - denotes required fields

Family Information

	First Name:*	Last Name: *
	Type*
	Home Phone:	Cell #: Work #:
	Email:*	(Emails are kept confidential)

	Address: *
	City: *	State: * Zip: *
	Emergency Contact (Include name, address, phone number, e-mail)*

Students entered below will be added to your family's account

Questions/Options:


Age*
Height and Weight*
Name of current ballet school. Include city and state.*
Number of BALLET classes per week (do not include other forms of dance)*
Total years of BALLET training?*
Is the applicant currently registered to attend the 2020 5-Week Summer Ballet Program or 2020 August Course program?*
Has the applicant attended a CPYB program in previous years?*
Reference #1: Personal reference. Please list the name, organization, phone, e-mail, and relationship.*
Reference #2: Dance Reference. This should be an instructor or director of your school. Please list the name, organization, phone, e-mail, and relationship.*
How did you hear about the Male Scholarship Program?*

Additional Information:

VIDEO SUBMISSION

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I've read the above and agree.

APPLICATION SUBMISSION

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NO FEE

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Enter your Full Name: