PROFESSIONAL COURSE APPLICATION

COURSE SELECTION

CONFIRM YOUR COURSE SELECTION

Please select the course you are applying for Required

Professional Course

AGE GROUP

Please select your age group: Required

9 - 11 years

12 - 14 years

15 - 18 years

APPLICANT INFORMATION

PERSONAL INFORMATION

Name

Date of Birth

Mobile Phone Number

Home Phone Number

Address

Headshot Photo

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Full Length Photo

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PARENT OR GUARDIAN INFORMATION

Parent / Guardian Name 1

Parent / Guardian Name 2

If you are under 18, please provide a parent / guardian email

EMERGENCY CONTACT DETAILS

Name

Relationship to Applicant

Mobile Phone Number

Home Phone Number

GP Surgery

GP Name

GP Phone Number

SUPPORT SERVICES & REASONABLE ADJUSTMENTS

In order that Italia Conti can provide appropriate support for you, please tell us about any particular health or medical conditions, disabilities, learning difficulties or domestic issues that you may have which significantly affect daily life. Any medical information you provide with us will be shared with the appropriate people in the case of an emergency.

Further details (if necessary)

Have you had learning support before?

Yes

Have you had special arrangements for exams before?

Yes

ETHNICITY

Monitoring of ethnic origin is voluntary and information supplied will only be used for statistical purposes and will be treated as confidential.

NATIONALITY

Place of Birth

Entry Date (if less than 3 years)

Do you have any unspent convictions or pending court cases?

Yes

ACADEMIC QUALIFICATIONS

Please list all your educational qualifications, for example any SAT's, GCSE's, BTEC's, A-Levels, etc. You may be required to present copies of your results if offered a place.

FIRST EDUCATIONAL ESTABLISHMENT | PRIMARY SCHOOL (or equivalent)

Name of Primary School

Start Date

End Date

Qualifications

Have you received your certificates?

Yes

SECOND EDUCATIONAL ESTABLISHMENT | SECONDARY SCHOOL (if applicable)

Name of Secondary School

Start Date

End Date

Qualifications

Have you received your certificates?

Yes

THIRD EDUCATIONAL ESTABLISHMENT | COLLEGE / SIXTH FORM (if applicable)

Name of College / Sixth Form

Start Date

End Date

Qualifications

Have you received your certificates?

Yes

PERFORMING ARTS TRAINING

PREVIOUS TRAINING

Name of Performing Arts School

Please list your previous performing arts training

VOCATIONAL QUALIFICATIONS | DANCE / DRAMA / SINGING / MUSIC (if applicable)

Qualifications

FINAL DECLARATION

PERSONAL STATEMENT

Please state in no more that 150 words why you have applied for Italia Conti and why you think you have the necessary potential to succeed

REFERENCE FROM EDUCATIONAL ESTABLISHMENT

Please upload a reference from your school or college, or alternatively please email this to guildfordassociates@italiaconti.co.uk

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APPLICATION TO ITALIA CONTI

CONDITIONS OF ENROLMENT

1. Pupils enrolled for the part time courses are required to obey the rules and conditions of the academy.
2. Any pupil unable to attend class should notify the office on 01483-568070 or contact Carrie by email: carrieRobinson@italia-conti.com
3. The directors do not accept responsibility for money or articles lost on the premises.
4. The directors reserve the right to amend or alter the rules and conditions of Italia Conti at any time.
5. The directors reserve the right to alter fees and classes without prior notice.
6. The directors reserve the right to ask a pupil to be removed from the course for any of the following reasons
A) lack of response to training.
B) misbehaviour, lack of respect to staff or other pupils, wilful damage.
C) poor attendance
D) breach of any rules and regulations of Italia Conti
E) late or non-payment of fees
7. In the event of an epidemic, national crisis or any circumstances over which the directors have no control, fees will not be returned or any compensation made whatsoever.
8. Parents and associates are only permitted to watch classes during the final week of term and then at the head of the school’s discretion.
9. I allow still or video pictures to be taken of training, promotion or show productions.
10. Pupils are required to wear the official Italia Conti Associates uniform for ALL classes.

CONFIRMING YOUR UNDERSTANDING

- I acknowledge that I understand the entry requirements, guided learning hours, the nature of the study programme and progression opportunities it may lead to.

- I can confirm that this course is suitable for me.

- I understand that, should I require it, additional support is available to me in the form of extra help with my studies / disability support / educational guidance / counselling.

- I agree to adhere to the Italia Conti Conditions of Enrolment, which I have read and fully understood.

- I comply with Italia Conti's Privacy Policy in relation to GPDR and how my data will be stored.

- I confirm that I have read and agree to the conditions of enrolment.
- I understand that fees are payable on or before the first day of each term.
- In the event of withdrawal, I agree to give a half term’s notice of such intension, in writing or pay the equivalent of one term’s fees in lieu.
- In the event of late payment Italia Conti may charge interest at the rate of 3% over the current base lending rate as published by Lloyds PLC, plus an administration cost of £10.00.

GDPR DECLARATION

- Italia Conti Arts Centre will only collect information in line with the relevant services we provide.
- The Arts Centre will retain information during the relationship, retaining your information in line with the data retention ruling. We will keep records for six years after the relationship ends in accordance with HMRC ruling.
- Personal data will be permanently deleted in accordance with the retention period above.
- Paper records are stored in locked cabinets accessed only by the Arts Centre management team.
- No personal information will be passed to companies or groups and is for the use of Italia Conti only.

POLICIES

Further information and policies can be found here: www.italiaconti.com/about-us/policies/

DIGITAL SIGNATURE

I agree to the terms & conditions

Date of Application

AUDITION FEE

It is a requirement to pay an audition fee (£35) to secure your audition date. We will not be able to process your application without this.

Please enter the account holders name who will be making the audition fee payment. Please ensure this is the same name that is on your payment account so we can correctly identify your payment.

Name of Payee

Pleae select audition fee payment

Audition Fee - £35

THANK YOU FOR YOUR APPLICATION TO ITALIA CONTI