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Young Playwright Application Form

First Name	(required)
Last Name	(required)
Email	(required)
Age	(required)
Phone	(required)
Parent or Guardian's Phone
City	(required)	- Select - Kitchener Ottawa West Regent Park St. Catharines South Etobicoke Tarragon Village Thunder Bay Winnipeg
Past art-related experiences (optional)
Please write a short paragraph about where you live (factual or fictional)	(required)