IOWA CENTER FOR THE ARTS
DANCE SCHOLARSHIP
Application Form
Complete and Return to:
Audition Dates:
October 24 or 25, 2013 or
February 27 or 28, 2014
Undergraduate Program
University of Iowa Dance Department
E108 Halsey Hall
Iowa City, IA 52242-1000
Application Deadline:
Fall: October 21, 2013
Spring: February 24, 2014
Phone: 319-335-2228
E-mail: eloy-barragan@uiowa.edu
A. BACKGROUND
Name:_______________________________________________
First
Last
Middle Initial
Social Security Number
Address:_____________________________________________
Street
City/State
__________________
(
Zip
)_____________
Telephone
Parents/Guardians:_________________________________________________________
High School Name:______________________
Telephone: (
)____________
School Address:____________________________________________________________
Street
City/State
Zip
Principal:___________________________ Guidance Counselor:____________________
Cumulative High School GPA (on a 4-point scale)___
ACT Composite/SAT Combined Score___
Class Rank___/___
(Top ____%)
ACT Subscores: (E:___M:___R:___S:___ W:__ )
(accurate to the nearest 10th percent)
Primary Dance Instructor(s)_________________________________________________
B. ESSAY
Write an essay about an aspect of dance that most appeals to you. Your paper should be typed,
stapled in the upper left corner, and range from 250 to 1,000 words. Be sure your name and
social security number appear on each page of your essay. Essays will be judged on creative
expression and language skills.
C. APPLICATION CHECKLIST
Please check the following items to be sure you have completed them. All items must be
checked when sending in this application.
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I am submitting, along with this form, a 4x6 photo of myself.
I am submitting, along with this form, my high school transcripts.
I am submitting, along with this form, 3 letters of recommendation.
I am submitting, along with this form, my essay.
I have submitted the Undergraduate Placement Audition Form.
I am prepared to present a solo at my audition.
D. DANCE SCHOLARSHIP AUDITION INFORMATION
Audition dates and times must be established in advance. As a candidate for this scholarship,
you will and perform a solo of any style. See top of this application for current audition times. No
costumes are needed; please bring appropriate shoes.
E. VERIFICATION
The University is requesting this information to evaluate your application for the Iowa Center for
the Arts Scholarship Program in Dance. Responses to all items are required in order to permit
your application to be considered. It is the policy of the University not to release information
about students (prospective or current) without their permission. You signature below authorizes
The University of Iowa to disclose this information, which you have supplied voluntarily, in
connection with publicity concerning you and you participation in the Iowa Center for the Arts
Scholarship Program in Dance. Information relating to academic performance (i.e., GPA, test
scores, and class rank) will not be disclosed, however, without separately obtained authorization.
Date:__________________
Signed:_____________________________________________
TO BE COMPLETED BY YOUR HIGH SCHOOL GUIDANCE COUNSELOR:
I hereby certify that the above named student’s GPA (on a four-point scale), class rank,
and test score as reported are correct and that required official transcripts were (will be)
sent on _______________.
month/day/year
Date:_________________
Title:_______________
Signed:_____________________
The University of Iowa does not discriminate in its employment or in its educational programs and activities on the
basis of race, national origin, color, religion, sex, age, disability, or veteran status. The University also affirms its
commitment to providing equal opportunities and equal access to University facilities without reference to affectional
or associational preference. For additional information on non-discrimination policies, contact the Coordinator of Title
IX, Section 504, and ADA in the Office of Affirmative Action, telephone (319) 335-0075, The University of Iowa, 202
Jessup Hall, Iowa City Iowa 52242-1316.