The Valle Academy of Performing Arts - Application Form

STUDENTS FIRST NAME *

STUDENTS LAST NAME *

STUDENTS DATE OF BIRTH *

STUDENTS AGE *

GENDER *

MALE

FEMALE

PREFER NOT TO SAY

FULL ADDRESS *

POST CODE *

CONTACT EMAIL *

PLEASE CONFIRM EMAIL *

HOME TELEPHONE NUMBER *

WHAT SCHOOL DOES THE STUDENT CURRENTLY ATTEND (If Applicable) *

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 (Students aged under 18 years)

MOTHERS OCCUPATION

MOTHERS MOBILE NUMBER

MOTHERS EMAIL

PLEASE CONFIRM EMAIL

MOTHERS PREFERRED CONTACT METHODS *

EMAIL	MOBILE
HOME NUMBER

FATHERS NAME (Students aged under 18 years)

FATHERS OCCUPATION

FATHERS MOBILE NUMBER

FATHERS EMAIL

PLEASE CONFIRM EMAIL

FATHERS PREFERRED CONTACT METHODS

EMAIL	MOBILE
HOME NUMBER

WHO WOULD YOU PREFER US TO CONTACT FIRST? *

WHICH CLASS/CLASSES ARE YOU INTERESTED IN?

	you must have at least one item
SATURDAY STAGE 1 MUSICAL THEATRE WORKSHOP 4-7 YEARS	you must have at least one item
SATURDAY STAGE 2 MUSICAL THEATRE WORKSHOP 6-7 YEARS	you must have at least one item
SATURDAY MUSICAL THEATRE WORKSHOP 8-13 YRS	you must have at least one item
TUESDAY STAGE 1 MUSICAL THEATRE WORKSHOP 4-7 YEARS	you must have at least one item
TUESDAY STAGE 2 MUSICAL THEATRE WORKSHOP 6-7 YEARS	you must have at least one item
WEDNESDAY MUSICAL THEATRE WORKSHOP 8-13 YEARS	you must have at least one item
WEDNESDAY YOUTH THEATRE COMPANY 13-17 YEARS	you must have at least one item
VALLE ADULT MUSICAL THEATRE COMPANY 18 YEARS +	you must have at least one item
ACTING (SUNDAYS)	you must have at least one item
STAGE AND TV ACTING (THURSDAYS)	you must have at least one item
PRIVATE ACTING (BY ARRANGEMENT)	you must have at least one item
BALLET	you must have at least one item
TUESDAY TAP	you must have at least one item
MODERN	you must have at least one item
STRETCH & JAZZ	you must have at least one item
LYRICAL	you must have at least one item
CHEER KIDS	you must have at least one item
CHEERLEADING	you must have at least one item
STREETDANCE	you must have at least one item
ACRO DANCE	you must have at least one item
BEGINNERS BALLET (FRIDAYS)	you must have at least one item
BEGINNERS BALLET (SATURDAYS)	you must have at least one item
TINY TAP (FRIDAYS)	you must have at least one item
WEENIE BOPPERS (FRIDAYS)	you must have at least one item
FAIRY FOOTSTEPS (SATURDAY)	you must have at least one item
GROUP SINGING	you must have at least one item
PRIVATE SINGING (BY ARRANGEMENT)	you must have at least one item
ELDER-BERRIES BALLET (OVER 40'S)	you must have at least one item

HOW DID YOU HEAR ABOUT US? *

I AGREE TO THE ABOVE DETAILS BEING ENTERED ONTO OUR PARENTMAIL 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.