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BAC M-1 Student Visa Application Form
Please contact info@balanceartscenter.com if you have any questions regarding this program. We will be in touch within 1 week of submitting your application.
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Required Supplemental Materials: Letters of Reference, Interview, and Lesson
Please send 2 written letters of recommendation, resume, and photo to info@balanceartscenter.com 

An interview and private lesson with the course director, Ann Rodiger, is part of the application process. Upon receiving your application we will reach out to schedule your interview and lesson.
Surname/Primary Name *
Given Name *
Preferred Name *
Passport Name *
Preferred Pronouns *
Required
Country of Citizenship *
Date of Birth *
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City of Birth *
State/Province of Birth
Country of Birth *
Mobile Phone (Including Country Code / Area Code and phone number) *
Email: *
Language (Check all that apply)
Permanent Address (Include Street, City, State/Province/Region, Postal/Zip Code, Country) *
USA Address - If Applicable (Include Street, City, State, Zip Code, Country)
Which type of student are you? *
Country of Citizenship *
Passport Number *
Passport Issued From *
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YYYY
Passport Expiration Date *
MM
/
DD
/
YYYY
Current Visa Type *
High School/GED Graduation Date *
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College or University Attended *
Field of Study at College/University *
Course of study you are applying for: *
Describe your interest in the Alexander Technique: *
Describe your previous AT experience (not required). Include teachers, programs, and locations.
What is your current profession? *
How did you learn about the BAC M-1 Visa?
Is there anything else you'd like us to know?
Write your name on the line below to signify that you understand and agree that all the information submitted here is factually true and honest.
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