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* 1. Student Name

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* 2. Has this student performed in public before?

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* 3. Check all of the Theater Education Disciplines that interest this student

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* 4. My student is very comfortable performing and speaking in front of others

1 5 10
i We adjusted the number you entered based on the slider’s scale.

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* 5. My student most wants to try (Check the top 3)

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* 6. As a parent/guardian I am most hoping that Pistarckle helps my student

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* 7. On an average day my student spends how many hours engaged in reading,
writing, creative arts or physical activity

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* 8. How prepared do you think your student is to begin entering the world of work and be successful based on school, personal habits, motivation, curiosity, etc...?

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