Solo Title Scholarship Application 2027

SOLO TITLE SCHOLARSHIP APPLICATION

2027
DIVISION:
Please choose your division:
ENTRANT'S PERSONAL INFORMATION:
Name of Entrant:

First NameLast Name
Name of Parent or Guardian:

First NameLast Name
Parent Cell:

xxxxxx-xxxx
Parent Email:
example@example.com
Entrant's Birthdate:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearmm-dd-yyyy
Dancer Age (as of June 1st, 2027)
Days
Age As Of Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
PICTURES AND FACTS SHEET:
PRIOR to uploading, label as follows: Jane Doe - Personal Fact Sheet - Petite Miss / John Doe - Headshot - Junior Mister / Jane Doe - Dance Pose - Miss / John Doe - Name of Routine - Mister

Please make the photos a vertical shot for both headshot and dance pose.
Picture - HEADSHOT

Browse Files or Drag & Drop
File MUST be submitted in jpg, jpeg, or png Cancelof
Picture - DANCE POSE

Browse Files or Drag & Drop
File MUST be submitted in jpg, jpeg, or png Cancelof
PERSONAL FACTS SHEET

Browse Files or Drag & Drop
Fact Sheet MUST be submitted in a Word Document Cancelof
ENTRANT'S ROUTINE INFORMATION:
Name of Song:
Type of Dance:
Time of Routine:
00:00 (minutes:seconds)
Prop Size:
Music Cue:
Enter:
TEACHER OF RECORD INFORMATION: The Teacher of Record, Teacher(s) of Recognition, and Chaperone (if required) must be registered for the full National Convention and a DMA Member in good standing if listed on this application. The Teacher of Record must be same Member who signed the Chapter Competition Application as Teacher of Record.
Name of Teacher of Record:

First NameLast Name
Chapter:
Teacher Cell:

XXXXXX-XXXX
Teachers Email:
example@example.com
Teacher(s) of Recognition:
(Cannot be the same as the Teacher of Record.)
Choreographer Name:
Status of Choreographer:
MEDICAL AUTHORIZATION That I, First NameLast Name , am the parent and legal guardian of First NameLast Name a minor child (under the age of eighteen (18) year of age) give my permission to DMA Heart of America Chapter 28, the Officers of the organization, Directors, and Assistants of the Competition to obtain whatever medical and/or hospital care and treatment may be deemed necessary at the DMA Chapter #28 Title Events from November 5 - 7, 2026.
Signature
Date of Signature:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
SPECIAL NOTICE

The entrant, the parent, and the Teacher of Record are responsible for the contents of this application. They are also responsible for making sure the entire JotForm is complete with all downloads. All fees must be mailed to the Treasurer NO LATER than January 15, 2025.
Should be Empty:

SOLO TITLE SCHOLARSHIP APPLICATION