RFA Summer Camp Registration Form

RFA Scholarship Request Form
Camper Information

Fill out this form to request a scholarship for the Roxy Film Academy Summer Camps. We will be reaching out to you with more information via email regarding the status of your scholarship application. Awarding of scholarships is based on availability and need and is not guaranteed. Feel free to contact us at learn@theroxytheater.org if you have any questions.
Camper's Name*

First NameLast Name
Age *
Which camp would they be attending?*

Elementary & Middle School Camp: Session 1: June 15th - June 19thElementary & Middle School Camp: Session 2: June 22nd - June 26thHigh School Camp: July 6th - July 10th & July 13th - 17thMusic Video & Rock Camp: July 20th - July 24th & July 27th - 31st
Parent/Guardian's Information
Name*

First NameLast Name
Cell Number*
E-mail*
This email will be used to reach out to you with further camp information.
Scholarship Information
Are you requesting a full or partial scholarship?

Full ScholarshipPartial Scholarship
If requesting a partial scholarship, how much can you afford to pay?
Is there any information you would like us to know regarding your circumstances?
We will be reaching out to you soon about the status of your scholarship application. Please get in contact with us if you have any questions. Thank you!
- Email us at Learn@TheRoxyTheater.org
- Call Ken at (406) 541-9367 or The Roxy Theater at (406) 728-9380
- Talk to us at the Roxy Theater Box Office. We open a half hour before the first film each day. Check our website for more information: https://www.theroxytheater.org/
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RFA Scholarship Request Form

Parent/Guardian's Information

Scholarship Information