2019 Personal Information Form

Welcome to the 2023 Apprentice Program! This form is to help us gather some important information about you before the summer begins. Personal Information on the top of this form may be shared with the following people as necessary: Academy Director, Academy Coordinator, Stage Managers, CSC Senior Staff. If there is something you wish to share more confidentially, please reach out to Victoria at vtownsend@commshakes.org or 781-710-4766 *

Check to acknowledge

Name (exactly as you wish it to appear in printed materials) *

Pronouns

For example: She/her/hers; They/Them/Theirs; He/Him/His

Occasionally, CSC may provide meals and/or snacks to Apprentices. Please tell us of any dietary restrictions. *

Medical Information

In the event of a medical emergency please notify: *

First

Last

Emergency Contact 1

Phone *

Emergency Contact 1

Relationship *

Emergency Contact 1

Second Emergency Contact, if applicable

First

Last

Emergency Contact 2

Phone

Emergency Contact 2

Relationship

Emergency Contact 2

Known Allergies

Medicines Taken

Insurance Carrier and Number

Physician's Name and Phone

Any ongoing treatments or conditions you wish to disclose at this time?

Please include any other information you would want known in a medical emergency

Is there anything else you would like us to know?

Self Evaluation

Please take time to fill out the following information thoughtfully and thoroughly. We find that actors who take the most away from the Apprentice Program are those that come in with specific goals that they want to accomplish. The process of cataloging this information can serve to help you identify your own specific strengths and challenges regarding your current craft and training, as well as areas to explore. The information will only be shared with the Apprentice Program Director, Coordinator, ARC Directors, and Faculty. (Please note: your answers here will not affect any showcase casting decisions!)

Class Work

In the below section, please rate your comfort in voice and text work. Using a 1-5 scale. A rating of “1” would indicate that you consider your voice to be untrained with at least a few bad habits or obstacles to overcome and a rating of “5” would indicate that you consider yourself to be well trained and experienced in that area. Tell us a little about why you chose the rating you did. Secondly, please provide one specific strength you have in each area as well as one specific challenge you face/goal that you hope to accomplish or work towards this summer. A reminder that this is a place to be honest about strengths and challenges so that we can work together for your growth this summer!

Voice Rating *

Voice Strength *

Voice Challenge/Goal for summer*

Text Rating *

Text Strength *

Text Challenge/Goal for summer*

Additional Goals

Please list any other goals for the summer that you want to bring to our attention. These may include professional goals, personal growth goals, or other artistic goals not otherwise included here.

What are you looking for?

Medical Information

Self Evaluation

Class Work