The Valle Academy of Performing Arts - Application Form

STUDENTS FULL NAME

STUDENTS DATE OF BIRTH

STUDENTS AGE

ADDRESS INCLUDING POST CODE

HOME TELEPHONE NUMBER

WHAT SCHOOL DOES THE STUDENT CURRENTLY ATTEND

Please list below any relevant experience regarding shows ie: Professional / Amateur and School
productions, together with any examinations passed. (Please note parts played and examinations
board & pass marks).

DOES YOUR CHILD HAVE A MEDICAL CONDITION WE SHOULD BE AWARE OF?

YES

NO

IF YES - PLEASE GIVE DETAILS

MOTHERS NAME

MOTHERS OCCUPATION

MOTHERS MOBILE NUMBER

MOTHERS WORK NUMBER

MOTHERS EMAIL

PLEASE CONFIRM EMAIL

MOTHERS PREFERRED CONTACT METHODS

EMAIL	MOBILE
HOME NUMBER	WORK NUMBER

FATHERS NAME

FATHERS OCCUPATION

FATHERS MOBILE NUMBER

FATHERS WORK NUMBER

FATHERS EMAIL

PLEASE CONFIRM EMAIL

FATHERS PREFERRED CONTACT METHODS

EMAIL	MOBILE
HOME NUMBER	WORK NUMBER

WHO WOULD YOU PREFER US TO CONTACT FIRST?

WHICH CLASS/CLASSE ARE YOU INTERESTED IN?

	you must have at least one item
SATURDAY COMBINED WORKSHOP 8-14 YRS
SATURDAY INTRODUCTORY WORKSHOP 6-7 YEARS
TUESDAY NURSERY WORKSHOP 4-7 YEARS
WEDNESDAY COMBINED WORKSHOP 8-14 YEARS
WEDNESDAY INTRODUCTORY WORKSHOP 6-7 YEARS
FRIDAY YOUTH THEATRE 14-17 YEARS
SPEECH & DRAMA (THURSDAYS)
SPEECH & DRAMA (SATURDAYS)
PRIVATE VOICE COACHING (BY ARRANGEMENT)
BALLET (MONDAYS)
TAP (TUESDAYS)
MODERN (THURSDAYS)
CONTEMPORARY (MONDAYS)
CHEERLEADING (FRIDAYS)
STREETDANCE (MONDAYS)
STREETDANCE (THURSDAYS)
MUSICAL DOTS (THURSDAYS)
BABY BALLET (FRIDAYS)
TINY TAP (FRIDAYS)
WEENIE BOPPERS (FRIDAYS)
GROUP SINGING (SATURDAYS)
PRIVATE SINGING (BY ARRANGEMENT)

HOW DID YOU HEAR ABOUT US?

I AGREE TO THE ABOVE DETAILS BEING ENTERED ONTO OUR HOMECONTACT SYSTEM - DETAILED ON OUR WEBSITE

YES

NO

I AGREE TO THE TERMS AND CONDITIONS ON OUR APPLICATION FORM - DETAILED ON OUR WEBSITE

YES

NO

SIGNED - PLEASE COMPLETE FULL NAME & DATE

All information given is held in confidence and conforms to our Data Protection policy.

Indicates Response Required