Homegrown Company Spring 2017: Registration Form
This information is only for Battersea Arts Centre's database.
* Required
Pick an audition slot:
*
11am-12.30pm
2-3.30pm
First name:
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Your answer
Surname:
*
Your answer
Address
*
Your answer
Post code:
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Your answer
Home phone number:
Your answer
Mobile phone number:
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Your answer
Email address:
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Your answer
Date of Birth
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MM
/
DD
/
YYYY
Age:
*
Your answer
Emergency contact name:
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Your answer
Emergency contact number:
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Your answer
Emergency contact relationship (parent, guardian etc):
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Your answer
School/College/University (if applicable):
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Your answer
Name of Music/Drama/Course teacher (if applicable):
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Your answer
Please select what you think best describes your ethnic origin:
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White British
White Irish
White and Black Caribbean
White and Black African
White and Asian
Other mixed background
Caribbean
African
Indian
Pakistani
Bangladeshi
Other Asian background
I do not wish to state my ethnicity.
Other:
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.
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Yes, I would like to apply for a subsidised place.
No, I will not be applying for a subsidised place.
How did you hear about Homegrown Company?
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Twitter
Facebook
Email
Poster or Flyer
School
Other:
Please send me emails about Homegrown workshops and events:
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Yes, please!
No, thank you.
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