APPLICATION FORM

YOUNG PEOPLE’S ‘ENGAGE’ PROGRAMME

PRIVATE & CONFIDENTIAL

Year of Entry

Surname
First name(s)
Date of birth
Age
Gender
Ethnicity
Parent/Guardian Details
Parent/Guardian name
Parent/Guardian contact address
(please inform us of any change of address)
Home telephone
Mobile telephone
Email

Course for which you are applying

(If you are filling in the form electronicallyplease tick the relevant optionby double clicking the appropriate box and choosing the ‘checked’ option in the ‘default value’ box)

SATURDAY PROGRAMME / YOUNG ACTORS WORKSHOP
Monday evenings
5.30pm – 8.30pm
10.00am – 11.00am
Acting 6-8 years
11.00am – 1.00pm
Acting 9-11 years
Acting 12-14 years
Acting 15-18 years
Song & Dance 6-11 years
1.30pm – 3.30pm
Performance Mix 12-18 years
TV and Film 12-18 years / 15 – 18 years
19 – 24 years

Education

Name and address of the school your child attends

Other information

Are there any medical conditions or special requirements that we should be aware of?
Does your child have any friends also attending with whom they would like to share a class? (if yes, please give their names - maximum 2 names)
Where did you hear about the class?

Ethnic Origin (please note we are asked to provide the following information for monitoring purposes)

White Black British Black African Black CaribbeanBlack Other

IndianPakistani Bangladeshi Chinese Asian Other

Other______

I confirm that the above information is correct

Signed
(Parent/Guardian)
Date

Please note:

The enrolment process:

◦ Once we have received your application you will contacted and placed on a waiting list. Students can be expected to be enrolled by the next term, or current term subject to availability.

◦ We will always endeavour to place students with their friends, but it is inevitable at some points this may not be possible.

(this is to ensure that class/groupsizesare evenly spread and students are working within their correct age range.)

◦ A good level and understanding of English is essential to participate in our classes.

The Haringey Young People’s Bursaries:

◦ Thanks to generous funding from the Tottenham Grammar School Foundation we are very happy to offer the ‘Haringey Young People’s Bursaries. Each bursary provides a tuition a fee discount (ranging from 30% - 100%) to eligible students. To be eligible for a bursary, students must meet certain criteria; please contact us for more info.

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