NEA ADJUDICATORS’ FORUM 2017
APPLICATION /REGISTRATION FORM PART 1:
Kindly provide the following information and return by e-mail to .
If you need to revert to the fax option, please write legible and fax to (011)787-3534.
1. PERSONAL DETAILS:
TITLE, NAME & SURNAMEID NUMBER
HOME ADDRESS
POSTAL ADDRESS
POSTAL CODE:
TEL (H) / TEL (W)
CELL. / FAX
E-MAIL (ONE only!)
2. BANKING DETAILS
ACCOUNT NAMEBANK
ACCOUNT NUMBER
BRANCH AND BRANCH NUMBER
TYPE OF ACCOUNT: / Cheque, Savings or Credit Card?
3. PROFILE:
Please provide a profile of not more than 150 words, highlighting your major achievements (to be displayed at the venues where you will adjudicate) in the box below and e-mail a recent picture of yourself (jpeg-format with your name as file name) to .
______
Signed:Date:
NEA ADJUDICATORS’ FORUM 2017
APPLICATION /REGISTRATION FORM PART 2:
Kindly complete the following:SURNAME AND NAME:
Please select your genre(s) of expertise:
Speech & Drama / Classical Music / Crossover Music / Contemporary Music / Dance / Indigenous Dance & Oral Traditions / Visual Arts
Please list your SPESIFIC SKILLS in selected genre(s) below:
(Eg. Classical Music: Piano, Vocal; Drama: All categories, poetry only, mime, public speaking, etc.); Dance: Hip-hop, etc.;
- Where applicable, please indicate language preference for adjudication purposes, e.g. English,Xhosa, Sepedi, etc.);
- When selecting Indigenous Arts, please indicate the relevant Cultural Grouping.)
KINDLY THE APPROPRIATE ANSWER TO EVERY QUESTION!
I am available for adjudication of the National Eisteddfod of South Africa™ 2017. / YES / NO
I have submitted anabbreviated CV of max. 150 words to . / YES / NO
I have submitted recent picture of myself (jpeg-format)to . / YES / NO
I have attached copies of my qualification(s) / Letter(s) of recommendation confirming my Prior Learning and Experience in adjudication and my field of expertise. / YES / NO
I am available for skills development and adjudication in less-serviced communities. / YES / NO
I am able and available to present training workshops at interested schools. / YES / NO
I am able and available to mentor new and inexperienced adjudicators. / YES / NO
I would like to attend the NEA Adjudicators’ Seminar to be presented in July 2017. / YES / NO
NEA ADJUDICATORS’ FORUM 2017
AVAILABILITY FOR ADJUDICATION IN 2017
SURNAME AND NAMEWILL YOU BE ADJUDICATING FOR OTHER FESTIVALS DURING 2017? If yes, kindly provide more detail of the festival, town / region and dates below. / YES / NO
NEA Adjudication Sessionsusually run from 15:00 until 19:00. (Kindly indicate the latest time you are available to adjudicate).
Do you have your own transport? / YES / NO
If your do not have you own transport, kindly indicate how will you get to any of the venues where you be required to adjudicate once accepted as a member of the Adjudicators’ Forum.
Kindly mark the REGIONS / provinces in the list belowwhere you will be available for adjudication.
Please indicate specific regions, towns, suburbs, etc. within the selected region(s) or provinces.
Available Regions
Kindly indicate specific regions, towns, suburbs, etc. within the selected region(s) or provinces.
Kindly email to or fax to 011-787-3534
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Kindly email to or fax to 011-787-3534 before 16:00 on Thursday 22 July 2016 1