Application for Dance and Music Specialisation Program

Student Information Student Information Please provide the detials any another sports currently played

First Name

Last Name

Email Address

Current School

Current Year Level

Current Teacher

Home Address

Parent/Guardian Information Parent/Guardian Information Please provide the detials any another sports currently played

Parent/Guradian 1 First Name

Parent/Guardian 2 First Name

Parent/Guardian 1 Last Name

Parent/Guardian 2 Last Name

Parent/Guardian 1 Mobile Number

Parent/Guardian 2 Mobile Number

Parent/Guardian 1 Email Address

Parent/Guardian 2 Email Address

Complete below if applying for dance Complete below if applying for dance Please provide the detials any another sports currently played

Complete below if applying for music Complete below if applying for music Please provide the detials any another sports currently played

Details of Current Dance Experience

Details of Current Music Experience

Current Dance Teacher/s or Studio

Instruments You Currently Play