FULLTIME REGISTRATION

APOLLO FULLTIME APPLICATION FORM

Please complete the below application form. All applicants must go through and application and audition process to ensure that they qualify for a place in the course. Once your completed application form has been reviewed by the course director your will be offered more information regarding audition day via email. PLEASE NOTE: Along with your application you are required to pay a $50 APPLICATION FEE, this is non-refundable and should be paid into the following account via online banking upon submitting your application. ANZ 06 0294 0944 081 00 (Please use applicants name and FT19 as reference e.g M Smith FT19)

PESONAL DETAILS

NAME: *

NAME:

First Name

Last Name

Date of Birth: *

Date of Birth

Nationality: *

Ethnicity: *

Eligibility to study in NZ: *

NZ Citizen

Australian Citizen

NZ Resident

CONTACT DETAILS

Phone Number: *

Mobile: *

Email: *

Address: *

EMERGENCY CONTACT

Emergency Contact: *

Relationship:

Phone Number: *

Mobile: *

MEDICAL

Known medical conditions: *

History of bone, ligament or muscle injuries:

Physical impairments:

Doctors Name: (If invited to audition you will be required to present a medical certificate stating you are fit to take part in the course) *

Doctors Name: (If invited to audition you will be required to present a medical certificate stating you are fit to take part in the course)

First Name

Last Name

COURSE INFORMATION

What are your aims in undertaking this course? (e.g. what would you like to do upon completion of the course? *

Dance History: (Give a clear description of your highest or most recent examination results in each discipline. Include: Year, Organisation, Discipline, Level & Mark) *

Other dance experience or achievements: (please list other dance experience or qualifications) *

Current dance teacher or college: (Please include disciplines you are currently studying) *

Vocal Experience or other performance experience: *

What is your highest level of academic achievement? *

If "OTHER" please describe qualification and level:

What level or qualification are you currently studying?:

I CONFIRM THAT THE INFORMATION I HAVE PROVIDED ON THIS APPLICATION FROM AND IN THE SUPPORTING DOCUMENTATION IS TRUE AND CORRECT *

YES

I UNDERSTAND THAT IN SUBMITTING THIS APPLICATION I AM REQUIRED TO PAY A $50 ADMINISTRATION FEE, AND PROVIDE SUPPORTING DOCUMENT UPON REQUEST FROM THE DIRECTOR OF THE COURSE: *

YES