LiberatusSchool of Performing Arts by k27T31

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									Liberatus                                        School of Performing Arts
                                                                                        PLEASE ATTACH A
                                                                                       RECENT PASSPORT
                                                                                       SIZE PHOTOGRAPH

Doghouse Studios, Unit 1 Isis Trading Estate, Stratton Road, Swindon, SN1 2PG
Office: 01793 521425
Mob: 07825 248203
Email: office@liberatusdance.com
                                    Application for entry in September 2010
                                 Level 3 Diploma in Foundation Studies (Dance)

Please complete all sections and return your completed application to Liberatus with:
    A non-refundable audition fee of £25 (cheques made payable to Liberatus Llp)
    A passport size photograph
    A full body photograph
    If possible, a reference from your current dance teacher

PERSONAL DETAILS
Full Name:

Permanent Address:                                           Correspondence Address:




Postcode:                                                    Postcode:

Tel No:                                                      Tel No:

Mobile No:

Email:

Date of Birth:

Contact details of Parents / Guardians:
Name:

Address:




Postcode:

Tel No:
EDUCATION DETAILS: ACADEMIC
Full name and Address of most recent school / college:




Please give details of examinations passed or to be taken: (GCSE, AS, A Level etc)
Date             Examination            Subject                          Grade




EDUCATION DETAILS: PERFORMING ARTS
Full name and address of current dance school:




Name of Teacher:
If possible a brief reference is required from your current dance teacher.

Tel No:

Please give details of any dance and other performing arts training:
Subject:                 Years studied:         Most recent exam (if relevant):
Performing Experience:




Additional Information:
Give a brief account of your ambitions and why you wish to study at Liberatus.




DECLARATION
I confirm that I, the applicant, have completed this form to the best of my knowledge and the
information given is correct.

Signature of Applicant:                                                          Date:

If the Applicant is under the age of 18:

I, the parent or guardian, approve and give my consent tot this application.

Signature:                                                                       Date:

                  Completed forms and enclosures should be sent to:
                        Liberatus School of Performing Arts
                                 Doghouse Studios
                              Unit 1, Isis Trading Estate
                                    Stratton Road
                                       Swindon
                                        SN1 2PG

								
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