Fillable High School Thespian Troupe Activation Form 20192020 (City of Oakland)

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High School Thespian Troupe Activation Form 20192020 (City of Oakland)

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1
Annual troupe dues for 2019–2020 (8/1/19 - 7/31/20) = $ 129.00
Troupe activation fee (charter or reinstatement) = $ 100.00
New student inductees ______@ $35.00 each = $
Optional rush service fee ($50.00:
box above) = $
Total amount enclosed = $
Student membership cards and certicates needed by
(This is NOT a guaranteed delivery date.)
ITS Troupe Activation Authorization (required)
By signing below, the troupe director and principal indicate their agreement to the
terms of membership on page 2 of this application.
______________________________________ _________
Troupe director Date
______________________________________ _________
Principal Date
High School Thespian Troupe Activation Form 2019–2020
Check here for RUSH SERVICE
$50 additional charge – include payment below
FAXED or EMAILED forms (P.O./credit card), 5-business-day delivery. RUSH SERVICE
is not available for MAILED-IN forms. Errors on form will cause delays.
Check or money order enclosed. Please submit only one check or money order per school.
School purchase order document enclosed. P.O. number and administrator’s signature required.
Charge my: Visa MasterCard American Express
initial
Do NOT adjust credit card amount.
initial
Do NOT adjust P.O. amount.
Name on card
Signature
Credit card billing address
Account number
Expiration date CID/Card code
(Amex 4 digits; all others 3)
Payment and authorization. P.O. and credit card payments will be adjusted to reect correct fees as needed unless we are instructed NOT to do so below. If adjustments are
NOT authorized, processing will be delayed until complete payment is received.
School: School name
Address
City
State/Prov.
Zip/Postal code
Country
Phone
Ext. Best time to call Fax
Preferred troupe email required (monitored regularly by troupe director)
Troupe director: Prex Name: First Middle I. Last Sux
Job title Troupe director’s preferred rst name Male Female
Address
City State/Prov. Zip/Postal code Country
Personal phone Home Cell Best time to call
Personal email required (used as log-in ID) Birthdate (required -- mm/dd/yyyy)
Principal: Prex First Last
Sux
Principal email required
Type or print legibly in black ink.
First-time troupe charter
Reinstating a withdrawn troupe
Troupe no. (if known):
Not sure of prior aliation status
Revised 10/1/2019
INTERNATIONAL
THESPIAN SOCIETY
HONORING
STUDENT
ACHIEVEMENT
IN
THEATRE
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2
Terms of membership for ITS troupes. To be aliated with the International Thespian Society (ITS), a division of the Educational Theatre Association (EdTA),
a school's charter application must be successfully processed, annual troupe dues must be paid, and minimum membership requirements must be met. A
school-based student organization, a Thespian troupe or Junior Thespian troupe, is created. The school administration appoints the troupe director who becomes
the single, ocial representative of the school and troupe to EdTA. Troupe directors are subject only to the authority of the school's administration and the EdTA
Board of Directors. The troupe director is a professional member of EdTA as long as the troupe maintains active status. All correspondence from EdTA will be sent
to the troupe director's attention only. It is the troupe director's responsibility to forward all invoices and statements for processing as required by the school's
payment policies and procedures. The troupe director must authorize all transactions, orders, rosters, and membership queries EdTA receives from the troupe and
is responsible for keeping copies of all correspondences for the troupe record. The school agrees to be legally and nancially responsible for all troupe
activity. By signing on page 1, the troupe director and principal indicate their agreement to these terms as well as those set forth in the EdTA
Code of Regulations, Code of Professional Standards, policies, and the Thespian or Junior Thespian Troupe Handbook, which are available for
review at schooltheatre.org.
Student membership. All troupes are required to have a minimum active member base of at least 6 students within 12 months of the troupe’s activation. After
that, the troupe must have a total of at least 6 active members at the end of each school year (July 31st). In general, any student who has participated in at least
two productions for a total of 100 hours of work is eligible for International Thespian Society membership. Please list any new inductees' names and contact
information on the following pages along with their grades (9-12) for the current ITS school year, August 1 through July 31. Obtain correct spelling of name and
current address information from all inductees to ensure they receive their Dramatics magazine subscriptions. Do not copy from school records. There will be a fee
for replacement membership cards and certicates. Reporting gender is optional.
MAIL POLICY: A correct mailing address is required for induction. EdTA/ITS may share Thespian mailing information with colleges, universities, or other organiza-
tions that might be of interest to members. Thespians may opt out at any time by logging in to schooltheatre.org and updating their online member proles.
EMAIL POLICY: A correct email address is required for induction. EdTA/ITS does not release Thespian email addresses to third-party vendors but may deliver care-
fully screened oers and information on behalf of selected schools and organizations. Thespians may opt out at any time by updating their online proles.
BIRTHDATE POLICY: A correct birthdate and year is required for induction. Member birthdates are stored on secure servers and are for internal, EdTA/ITS use only.
They are not released to outside individuals or organizations. The combination of name and birthdate creates a unique identier to help avoid errors, reduce
duplicate records, and distinguish alumni in the future.
EdTA/ITS reserves the right to change these policies.
Returning the completed application form.
For fastest turnaround, submit this form using one of the methods suggested below. Suggestions are based on the payment type you chose on page one.
• Credit card payment. Submit form by fax to 513.421.7055. Do not send credit card information by email.
• Ocial school purchase order. Submit form along with a copy of the P.O. document as an email attachment to members@schooltheatre.org or by
fax to 513.421.7055. The purchase order must include a P.O. number and administrator signature.
• Check or money order. (RUSH SERVICE unavailable) Submit form by mail to:
Educational Theatre Association
PO Box 645084
Cincinnati, OH 45264-5084
Please keep a copy of this completed form for your records and allow three weeks from date of receipt for processing for your non-rush application.
Fees are in eect August 1, 2019 to July 31, 2020 and are non-refundable. Once submitted, inductions cannot be canceled and are non-transferable.
Certicates, membership cards, parent stickers, and induction pins for all new members listed will be mailed to the troupe director once this form and all mem-
bership fees are processed at the National Oce. Dramatics print subscriptions (one-year, bimonthly) will begin six to eight weeks after processing. By logging in
to schooltheatre.org, inductees may access digital issues of Dramatics magazine from induction through the year following high school graduation.
Your annual dues pay for troupe director benets including access to Theatre Educator Pro, Career Center, Mentor Match, discounts on events and merchandise,
and subscriptions to Dramatics and Teaching Theatre magazines (value $85). In addition to honor items, student benefits include exclusive ITS programs such as
chapter events, the International Thespian Festival, and International Thespian Excellence Awards. $19.01 of each student fee is payment for a subscription to
Dramatics magazine. All dues and fees also support the operation of the International Thespian Society and Educational Theatre Association. Note that a portion
of all induction fees is allocated to your chapter to support chapter programming.
Troupe management information is available online at schooltheatre.org/troupehandbook.
3
Active student members requirement: All troupes must have a total of 6 or more active student members within 12 months of troupe activation (charter or
reinstatement). This is the sum of:
a. Current students who are already inducted into my school's withdrawn troupe (if reinstating)
b. Current students who transferred, or do transfer, to this school after being inducted into another troupe
c. Students inducted into my troupe now or during the next 12 months
I understand that any troupe unable to meet this requirement could have its membership withdrawn, and there will be additional requirements and fees to
reinstate the troupe.
Signature (required) _________________________________________________________________________ ____________________
Troupe director Date
Use this form to induct any currently eligible students. Please type or print legibly. Gender, middle initial, sux and mail/email opt out are optional. All
other elds are required. If you have more than 9 students to induct, please copy and submit additional pages. Active troupes may induct online at any
time.
1. Name: First Middle I. Last Sux
Male Female Home address
City St./Pr. Zip or postal code
Email (required --used to access online benets) Birthdate (required -- mm/dd/yyy)
Grade:
9 10 11 12 Graduation year I do not wish to receive scholarship, college, or other information by: Mail Email
2. Name: First
Middle I. Last Sux
Male Female Home address
City St./Pr. Zip or postal code
Email (required --used to access online benets) Birthdate (required -- mm/dd/yyy)
Grade:
9 10 11 12 Graduation year I do not wish to receive scholarship, college, or other information by: Mail Email
3. Name: First
Middle I. Last Sux
Male Female Home address
City St./Pr. Zip or postal code
Email (required --used to access online benets) Birthdate (required -- mm/dd/yyy)
Grade:
9 10 11 12 Graduation year I do not wish to receive scholarship, college, or other information by: Mail Email
4. Name: First Middle I. Last Sux
Male Female Home address
City St./Pr. Zip or postal code
Email (required --used to access online benets) Birthdate (required -- mm/dd/yyy)
Grade:
9 10 11 12 Graduation year I do not wish to receive scholarship, college, or other information by: Mail Email
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4
5. Name: First Middle I. Last Sux
Male Female Home address
City St./Pr. Zip or postal code
Email (required --used to access online benets) Birthdate (required -- mm/dd/yyy)
Grade:
9 10 11 12 Graduation year I do not wish to receive scholarship, college, or other information by: Mail Email
6. Name: First
Middle I. Last Sux
Male Female Home address
City St./Pr. Zip or postal code
Email (required --used to access online benets) Birthdate (required -- mm/dd/yyy)
Grade:
9 10 11 12 Graduation year I do not wish to receive scholarship, college, or other information by: Mail Email
7. Name: First
Middle I. Last Sux
Male Female Home address
City St./Pr. Zip or postal code
Email (required --used to access online benets) Birthdate (required -- mm/dd/yyy)
Grade:
9 10 11 12 Graduation year I do not wish to receive scholarship, college, or other information by: Mail Email
8. Name: First
Middle I. Last Sux
Male Female Home address
City St./Pr. Zip or postal code
Email (required --used to access online benets) Birthdate (required -- mm/dd/yyy)
Grade:
9 10 11 12 Graduation year I do not wish to receive scholarship, college, or other information by: Mail Email
9. Name: First
Middle I. Last Sux
Male Female Home address
City St./Pr. Zip or postal code
Email (required --used to access online benets) Birthdate (required -- mm/dd/yyy)
Grade:
9 10 11 12 Graduation year I do not wish to receive scholarship, college, or other information by: Mail Email
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High School Thespian Troupe Activation Form 20192020 (City of Oakland)

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Completed 21 May 2022

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