ACT-SO STUDENT APPLICATION

NAACP ACT-SO COMPETITION APPLICATION
2021
NAACP Dane County #36AB

This section is to be completed by student applicant.

* Indicates required field

Student Name *

First

Last

Preferred Phone Number *

Home Address *

Line 1

Line 2

City

State

Zip Code

Country

Student's Primary Email *

Secondary Email *

NAACP Member? *

How Did You Hear About ACT-SO? *

Other ways you heard abour ACT-SO *

U.S Citizen? *

Returning Competitor *

Referred by: *

Date of Birth *

Age *

Gender *

Grade Level *

Student's High School *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Other High School if not listed, or Home School *

______________________________________________

ACT-SO COMPETITION CATEGORIES
Refer to the ACT-SO Category Descriptions and check the category or categories that you will compete in. Contestants may choose no more than three (3) categories. Within the categories shown below, please select your competition category or categories. Vocal music competitors, please indicate as specifically as possible your vocal range (e.g. soprano, contralto, tenor, etc.). Instrumentalists, please indicate your instrument (e.g. drums, piano, saxophone, etc.).

STEM (Science, Technology, Engineering & Math) *

CULINARY ARTS (Not Available in 2021) *

I'm interested. Contact me if this becomes available in 2021.

HUMANITIES *

VISUAL ARTS *

BUSINESS *

PERFORMING ARTS *

PERFORMING ARTS - DANCE *

PERFORMING ARTS - MUSIC *

Music: Vocal Range or Instrument *

Multiple areas of interest in any category? Enter here. *

____________________________________________________
PARENT OR GUARDIAN INFORMATION

Parent Information *

First

Last

Relationship? *

Parent's Email *

Home Phone *

Parent's Cell Phone *

Comments or Questions? *

___________________________________________________
THIS SECTION TO BE COMPLETED BY NAACP ACT-SO CHAIRPERSON

ACT-SO Chairperson: Frances Huntley-Cooper

[ ] This person is a gold medal winner and will advance to the National Competition.

Chairperson Signature: _____________________ Date: ___/___/____
_____________________________________________________

Submit

NAACP Dane County
Branch #36AB
P.O. Box 44366
Madison, WI 53744

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NAACP Dane County Branch #36AB is a 501-C4 organization.

                                                                         MORE NAACP INFORMATION
                         NAACP Wisconsin State
                       Conference of Branches
                              www.naacpwi.org                                                                                                                                                              National NAACP

NAACP ACT-SO COMPETITION APPLICATION2021NAACP Dane County #36AB

NAACP ACT-SO COMPETITION APPLICATION
2021
NAACP Dane County #36AB