Lewis & Clark ImmersiveSummer Theatre Program

Student Personal Information

Legal First Name

Preferred First Name

Legal Middle Name

Legal Last Name

Birthdate

Email

Mobile Phone

Do we have permission to text you with important information and updates?

YesNo

Mailing Address Line 1

Line 2

City

State

Country

Zip/Postal Code

Gender Identity

Pronouns

Are you a US Citizen, permanent resident, or hold refugee status in the US?

YesNo

High School Information

What is your current grade level?

Anticipated College Entry

e.g. Fall 2026

Where do you currently go to high school?

List the clubs, sports, and/or activities you participate in both inside and outside of high school

Additional Information

Have you attended a previous conference with us?

Yes, virtual conference Yes, in person conferenceNo

How did you hear about this program?

Please provide a link to a short video - no longer than 3 minutes total - of yourself performing any number of the following: a monologue, a song, a scene with an offscreen reader, or any combination of the three. Show us what you can do! Please upload your video to YouTube or Vimeo and provide an unlisted link below. No password protections, please.

Please provide us with supplemental material that you believe will help us get to know you as an artist. This can be a video of you demonstrating an additional skill (dancing, acrobatics, juggling, etc.), a work sample in the form of an audio or visual recording or written work, a resume illustrating your theatrical experience, a piece of visual or fine art, or anything else that will deepen our understanding of you. Use the text box below to provide a link, or the "Choose File" button to submit a document/file. You may upload more than one document, file, or link to more than one video.

Parent/Guardian information

Parent/Guardian 1 information

First Name

Last Name

Phone

Email

Parent/Guardian 2 information (optional)

First Name

Last Name

Phone

Email