NORTH SHORE PERFORMING ARTS SOCIETY (INC)

P O Box 33 111, Takapuna 0740 www.nspas.org.nz

ENTRY FORM: Dance

Convenor: Ms Nikki Reynolds Phone: 021 809 558

Email: or

Conditions and Rules are published in the Syllabus obtainable from the address above

and are also available from our website www.nspas.org.nz

CLOSE OFF DATE: 8 March 2016

Please Note: No Late Entries will be accepted.

Entries may be emailed to or posted to North Shore PAS, at

N Reynolds

1 Emmett Street

Herne Bay

AUCKLAND 1011
Please mark envelope Ballet/Jazz/Tap

FEES should be paid direct to ASB account 12-3015-0496524-03 by online transfer, fast deposit, or teller. The deposit must have the candidates name in the Reference box.

SURNAME / FIRST NAME
No & STREET / Age @1stt June / Male/Female
SUBURB / PHONE
CITY / MOBILE
AREA CODE / EMAIL
Teacher Name and Address
Teacher / Email: / Phone:
CLASS No. / CLASS DESCRIPTION / Ballet
Title MUST be entered for class: Character, Demi-Character, Barefoot, Song & Dance, Broadway Theatre / PERFORMER ENTRY FEE is $6.00 per class unless otherwise stated in Syllabus
ENTRY FEE
$
$
$
$
$
$
$
$
ADMINI/ENTRY / $30 / 00
(GST inclusive) TOTAL / $
I agree to be bound by the rules of NSPAC Society (Inc). I give permission for any official photographs to be used for publicity. Cameras & Video Cameras: You may photograph your own child or student only, but due to misuse of the privilege VIDEO recording is not permitted.
Dance School.______Dance Teacher ______
Signature……………………………………………………………………. / Checked by teacher……………………………………………..
Print name …………………………………………………………………. / Signature ………………………......