RISE Application Form
You are one step closer to joining our country-wide family

Email address *
If you are over the age of 21 - please follow this link to the correct application form for you to fill in:
Application form for students under the age of 21
I am under the age of 19 & in school *
First Name *
Your answer
Surname *
Your answer
Preferred Name/Stage Name
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Cellphone Number *
Your answer
Section Applying For *
Your Instagram Name
Your answer
Current Academic School *
Your answer
Allergies
Your answer
Applicant Resides with (Mother / Father / Both) *
Your answer
Parent's Details
Parent's First Name *
Your answer
Surname *
Your answer
Title
Your answer
Home Telephone
Your answer
Work Telephone
Your answer
Cell Phone *
Your answer
Email Address *
Your answer
Residential Address *
Your answer
Place of employment *
Your answer
Position Held *
Your answer
How did you hear about us? *
Your answer
I have read about the prices and venues for the course/workshop I'd like to apply for, before submitting this form. (All course information can be found at www.riseacademy.co.za) *
Required
A copy of your responses will be emailed to the address you provided.
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