2017 Fall High School/College Audition Workshop
Please complete one form per child.
Student's First Name
Your answer
Student's Last Name
Your answer
Student Gender
Your answer
Student's Date of Birth
Please enter the Month, Day and Year of the student's birth
Your answer
Current Grade
School Attending
Your answer
Street Address and Apt Number
Your answer
City
Your answer
State
ZIP
Your answer
Primary Adult first name
Your answer
Primary Adult last name
Your answer
Primary Adult relationship to student
Your answer
Primary Adult address and apt.
Your answer
Primary Adult city
Your answer
Primary Adult state
Primary Adult ZIP
Your answer
Primary Adult, primary phone
Your answer
Primary Adult, secondary phone
Your answer
Primary Adult, primary email
Your answer
Primary Adult, secondary email
Your answer
Student phone (if different)
Your answer
Student email (if different)
Your answer
Payment Method
PLEASE ELECTRONICALLY SIGN WITH YOUR FULL NAME BELOW
I understand that all payments are non-refundable and that my space in the class is not reserved until FULL payment has been received. - A minimum, non-refundable, 50% deposit is required. - Full payment is due 5 days prior to the first day of class. - Student's space is NOT guaranteed until FULL payment has been received. - A $5 credit card processing fee will be added to ALL credit card payments (online or by phone).
Your answer
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