Office use only Wac Arts REF: ______
Wac Arts Nites Application Form
for 11 – 25 year olds
(priority is given to 13-19’s)
Today’s Date ______
First Name ______Surname ______
Address ______Post Code ______
______Borough ______
Home Tel ( ______Mobile ( ______
Email: ______
Date of Birth ______Gender ______
Ethnicity ______
School/College/Occupation:______
How did you hear about Wac Arts Nites? ______
Classes you wish to attend - (Please write number of preference in the boxes next to the classes of your choice (1 = 1st choice, 2 = 2nd choice)
o Street Dance o Trampolining o Music Technology o Vocals
o Drum-Kit o Keyboards o Guitar o Band Nite
o Aerials/Silks o Drama o Other ______
o ‘Wonder’ Wac Arts – Performing Arts and Media Workshops for young people with learning difficulties
Please indicate below the level of experience you have had in these subjects, if any, either in school or elsewhere. Tell us how confident you feel in these subjects:
______
______
Do you have any physical limitations or medical conditions? o Yes o No
If ‘Yes’, please specify ______
Receipt of your application will be confirmed in writing, this does not automatically mean you have a place.
As we are a performing arts & media college we often use photographs, video footage for publicity
and / or screening purposes. I consent for photographs and video footage of my child to be used
for publicity purposes. Yes ¨ No ¨
All Wac Arts records are stored under reasonable security and can only be accessed by Wac Arts staff for proper purposes. Wac Arts is registered
with the information commissioner under the 1998 Data Protection Act. From time to time we may contact you regarding our programme or courses.
We will not pass on personal information to anybody else.