an application form - PCPA Theaterfest

Application
PCPA is the Pacific Conservatory of the Performing Arts of
Roger DeLaurier
Conservatory Director/Actor Training
Mark Booher
Associate Dean/Artistic Director
Michael J. Dempsey
Conservatory Director/Technical Theatre
CHECK PROGRAM (S)
2-Year Actor Training Program Acting Internship Summer Acting Program
2-Year Technical Theatre Training Program Technical Theatre Internship Summer Technical Theatre Program
Students applying for any of the above listed programs must submit a resume of theatrical experience, two letters of
recommendation, transcript from school most recently attended, mission statement/letter of intent, and full face
photograph (actor training only) with this form. There is no application fee. _
Questions? Call the PCPA Conservatory Office at (805) 928-7731 ext. 4115.
Name____________________________ Date_________
Social Security #_________________________
Home Phone __________________ Cell Phone ______________________ Work Phone _________________
Permanent Address until_____________________
Street____________________________________
City ___________________State_ ___ Zip________
E-mail_____________________________________
Are you a California Resident ?
Yes____ No____
Current Address until__________________________
Street______________________________________
City________________ State___ Zip____________
Date of Birth________________________________
Present Employer (business name & contact information)___________________________________________
_________________________________________________________________________________________
Name of High School Attended_ ________________________________________ State__________________
Education (List highest level completed)______
Dates Attended__________ Degree/Diploma_ _____________
Institution_ _____________________________ |_ _____________________ |_ __________________________
Emergency Contact Information
Name__________________________________ Phone (
)_________________________________________
Address__________________________ City _________________________ State _ _____Zip______________
Actors Only:
Height______________ Weight_____________ Hair________________ Eyes_______________
Gender_____________ Union Affiliations__________________________________________
Technicians Only:
List areas of preference
1.____________________________ 2._______________________________ 3._________________________
Mail application to:
How did you learn about PCPA?_ _______________________
__________________________________________________
PCPA Theaterfest
Attn: Conservatory Office
800 South College Drive
Santa Maria, CA 93454-9953

PCPA is the Pacific Conservatory of the Performing Arts of
References
(Technical Theatre Only)
1. Name ___________________________________________________
Address ___________________________________________________
_ _ ___________________________________________________
Phone: ___________________________________________________
2. Name ___________________________________________________
Address ___________________________________________________
_ _ ___________________________________________________
Phone: ___________________________________________________
3. Name ___________________________________________________
Address ___________________________________________________
_ _ ___________________________________________________
Phone: ___________________________________________________