Exit Scholarship Request: Lights! Cameras! Architecture! Question Title * 1. Student Name (First Name, Last Name) Question Title * 2. Student Age 7 years old 8 years old 9 years old 10 years old 11 years old Question Title * 3. Parent/Guardian Name (First Name, Last Name) Question Title * 4. Parent/Guardian Cell Phone Question Title * 5. Parent/Guardian Email Address Question Title * 6. Mailing Address (Street, City, Zip Code) Question Title * 7. Does the student have any dietary restrictions? Question Title * 8. Does the student have any allergies? Please let us know if the student requires any medical treatment during the program (allergy medicine, etc) Question Title * 9. May we use photos or video which include your student in Westcott communications? Yes No Question Title * 10. Students who receive the scholarship will receive a free tuition to this program. Please certify that: The scholarship will make it possible for my child to attend the program. My child will make an effort to attend all the sessions. Question Title * 11. T-shirt Size Youth S Youth M Youth L Youth XL Adult S Adult M Done