Jan Bax Family Foundation Scholarship Fund Request Application

Thank you for your interest in attending a Fox Cities Performing Arts Center performance. Please complete the scholarship request application and submit it electronically or print a hard copy to be mailed or faxed to the Fox Cities Performing Arts Center's Community Support Committee.  

Mail or fax to:
Fox Cities Performing Arts Center
400 West College Avenue
Appleton, WI 54911
(920) 730-3784

School or Organization:
Contact:
Street Address:
City, State, Zip:
Daytime phone:
E-mail:


Performance Information:

FIRST CHOICE
Title of performance you are interested in:

Date and time of performance:


SECOND CHOICE
Title of performance you are interested in:

Date and time of performance:

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Total number of tickets needed:

Total number of tickets requested for scholarship assistance:

Brief description of the group that would attend:


Explain why your school or organization is in need of scholarship assistance;include number of students receiving free or reduced lunch or other factors that affect your group's access to the performing arts:


Explain how this experience would benefit your group: