Application Form – Fulton Theatre

School Name*

School Address*

Street Address City ZIP Code

School Phone*

School Fax Phone

Name of Approving School Administrator*

First Last

Must be a principal, assistant principal or curriculum facilitator.

Administrator Title*

Administrator Email*

List known previous participation with Fulton Theatre programs. Specify the school year of each program.

Is your school Title 1?*

Did your school make AYP last year?*

Number of Students in the most recent school year*

% (Percentage) of students on free and reduced lunch in the most recent school year*

School Ethnic Makeup for the Most Recent School Year

Percentage of entire student body.

African American

Asian

Caucasian

Hispanic

Native American

Other

This application should be applied to*

Cost of Bus Transportation (If you are applying for these funds, enter the full cost of the buses from school to Fulton Theatre)

Primary Contact Name

First Last

Identify a person, if primary contact is different from the authorized school administrator.

Primary Contact Email