Performing Arts Award Nomination Form

Parents, mentors, or teachers may nominate 5th - 8th grade students to receive the Performing Arts Award from Chesterton Academy. This award recognizes students for their gifts in theater.

To be eligible for this award, a student must perform in a school or community production. Please use this form to notify us of your student's upcoming event, and we will do our best to send a representative to attend.

The award will be applied to the recipient's tuition freshman year.

Submitter Information

Your Name

First Name

Last Name

Phone

(###)

###

####

May we call you?

Yes

Relationship to Student

Examples... Parent, Teacher, etc...

Parent Contact Information

Please include parental contact information, so we can notify them of your nomination. Section not required if submitter is parent.

Parent Name

First Name

Last Name

Parent Email

Parent Phone

(###)

###

####

Nominee Information

Name

First Name

Last Name

Nominee's Current School

Nominee's Current Grade Level

What year will the nominee enter high school?

What is the name of the production the nominee will be performing in?

What day(s) and what time(s) will the nominee be performing?

Where will the nominee be performing? Please include an address.

Any additional comments or information

Have Questions?

Contact our executive director, Michael Casey, at 401-287-2280 or by email at mcasey@chestertonri.org