FOTAD
Merit Award Application
Print This, Fill In The Necessary Information,
And Return It To The Department,
Along With Other Required Materials, By February 12, 2010
Name: ______________________________________________________________
Phone: _____________________________________________________________
Current Address: _____________________________________________________
Home Address (if different): ____________________________________________
Social Security Number: _______________________________________________
Area of specialization (Dance, Performance, Design/Technical Theater, Theater Education): __________
Classification (Freshman, Sophomore, Junior, Senior): _________________________
Level of achievement (Apprentice, Journeyman, Master): _______________________
First semester and year attended SIUE: _____________________________________
If transfer student, list other institutions attended: _____________________________
Total number of hours completed at end of Fall Semester: _______________________
Cumulative Grade Point Average at end of Fall Semester: ______________________
Academic Advisor: ____________________________
Checklist of Items Included:
____ Awards Application Data Sheet
____ Letter of Application
____ Resume
____ Digital photo (can be cel phone photo) e-mailed to gconroy@siue.edu (new
this year)
____ Portfolio (Technical Theater applicants)
____ Teaching Portfolio (optional for Theater Education majors)
____ Current Transcript
____ Faculty Recommendation