Application form 2yr vocational sixth form in Performing Arts with Acting

Course applying for*

First name*

Surname*

Gender*

Male
Female
Prefer not to say

Date of Birth*

Age*

Correspondence address (please notify us if this changes)*

Postcode*

Parent/carer full name & title*

Parent/carer email*

Parent/carer phone number*

Relationship to applicant*

Address (please notify us if this changes)*

Post code*

Home Phone Number*

Mobile Number*

Email*

Emergency Contact Number*

Last school attended/currently attending*

Do you have any medical condition that the school should be aware of?*

If yes, please provide details

Do you have any Special Educations Needs (SEND)?*

If yes, please provide details

Do you have an EHCP (Education Health & Care Plan)?*

Do you qualify for FSM (Free School Meals)?*

Do you receive any exam dispensations?*

If yes, please provide details

Applicant's signature*

Date*

Parent/carer's signature*

Date*

Photo of Applicant

Education from secondary

Dates

Institution

Subjects & predicted grades Including LAMDA/Arts Award/TRINITY etc

Experience

Work Experience

Dates

Employer

Duties

Previous theatre training and/or experience (amateur & professional)

Further Information

Please write a brief statement telling us why you wish to be considered for this course*

First Aid*

By ticking this box, you are giving permission that in the case of an emergency, a faculty member may administer First Aid to your child. Also for a teacher/assistant to administer the contents of the ﬁrst aid kit when there is medical need. If you are not happy to do so please discuss this with one of the principals of the school.

Publicity Release

By signing this form, I acknowledge and understand that without any compensation or notiﬁcation to, or approval by the undersigned or Participant, the participants name, photograph, video, audio and biographical information may be used, reproduced or otherwise be disseminated or published by or on behalf of the Dorset School of Acting/youth theatre for any purpose, including, but not limited to, advertising and/or promotion of the Dorset School of Acting/youth theatre.

How did you hear about us?*

Other - please state