Registration
Please read the information below in order to be considered for the 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.


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.

Questions? Email us at 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:
How did you hear about the Male Scholarship Program?*
Age*
Height*
Weight*
Total years of ballet training?*
List previous training (include school(s) name, years attended, classes per week attended, city, state, school's e-mail/phone). Please use "Additional Information" below if needed.*
If you have studied previously at CPYB, please enter the program(s) (Academic Year, 5-Week Summer Ballet Program, August Course), year(s) attended and level(s) you were in.*
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.*
 
Additional Information:
 
VIDEO SUBMISSION
I understand that I must submit my audition video online via Youtube or Vimeo within 10 days of this application. I will receive a follow-up email to this application that will outline the requirements for the submission, including the deadline.
I've read the above and agree.
 
APPLICATION SUBMISSION
I understand that in order to be considered for the Central Pennsylvania Youth Ballet Male Scholarship Program, I must complete the above form in its entirety. Failure to do so will result in my application not being considered.
I've read the above and agree.
 
NO FEE
I understand that there is no fee to apply for the Male Scholarship Program.
I've read the above and agree.
 
Enter your Full Name: *   
 
Other Questions/Comments: