Application

Name:

Current Address
Street:
City:
State: Zip:

Phone:

E-mail address (Penn preferred):

Campus Address (if known)
College House:
Building name:
Room number:

Cell Phone:

Penn ID number (This is an 8-digit number in bold on your PennCard. You can also find it in your PennKey set up letter, or on CampusExpress if you set up your PennKey. Otherwise leave blank):

T-shirt size:

School and Academic Major:

Hobbies/Special Interests:

Optional Demographic Information:

Race/Ethnicity:

Gender:

Religion:

Are you taking any medication? If yes, please specify:

Are there any medical conditions of which we should be aware? If yes, please specify:

Please respond briefly to the following questions.

1. Why do you want to participate in PennArts?

2. What arts training do you have?

3. Finish this sentence: Art to me is . . .

4. What artist(s) do you admire and why?

Please feel free to send us any additional materials that you do not need returned, such as CDs, photos, etc. Additional materials should be fun and help us get to know you.

Choose one:
I am applying to this pre-orientation program only.

I am applying to more than one pre-orientation program. My preferences in order are:

1.
2.
3.
4.
5.

I understand the PennArts program is scheduled from Sunday, August 30 - Thursday, September 3, 2009. The cost of the program is $325.00 which I agree to pay immediately upon receipt of the acceptance packet. **

** Note: For those students eligible for financial aid through the University of Pennsylvania, limited financial assistance is available. Please indicate if you wish to be considered.

Yes, I am eligible for financial aid through Penn and wish to be considered for financial assistance to support my participation in the PennArtsprogram. (Any type of financial aid or work-study through the University qualifies).

Please submit your application by June 30, 2009. If you have questions, feel free to write Ty Furman in the Platt Student Performing Arts House.