Homegrown Company Spring 2017: Registration Form
This information is only for Battersea Arts Centre's database.
Pick an audition slot: *
First name: *
Your answer
Surname: *
Your answer
Address *
Your answer
Post code: *
Your answer
Home phone number:
Your answer
Mobile phone number: *
Your answer
Email address: *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Age: *
Your answer
Emergency contact name: *
Your answer
Emergency contact number: *
Your answer
Emergency contact relationship (parent, guardian etc): *
Your answer
School/College/University (if applicable): *
Your answer
Name of Music/Drama/Course teacher (if applicable): *
Your answer
Please select what you think best describes your ethnic origin: *
Please list any medical conditions or special needs we should be aware of e.g. allergies, dyslexia etc
Your answer
The fee for the term is £40. We have a limited number of subsidised places for those in the greatest need. Please check the box if you would or would not like to receive a scholarship form. *
How did you hear about Homegrown Company? *
Please send me emails about Homegrown workshops and events: *
Required
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