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
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms