Make an Application

Students Name: *

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Address: *

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Age: *

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Date of Birth: *

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Home Phone: *

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Present School Year: *

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Agent (if applicable):

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Your Email ( if over 17yrs ):

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Please list any tuition in drama / dance / speech / music(past and present) and level of achievement:

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Special Skills

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Parent(s) Name(s) *

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Please indicate if any teacher has referred or recommended drama classes

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Parents' Email *

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Parental Approval *

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Parents' Mobile Numbers *

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If student has any health issues, please describe here

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How did you find out about AYA?

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