D. Richardson Productions Performing Arts Program

1

LOCATION* This field is required.

PHILADELPHIA

MARLYLAND

ATLANTA

SOUTH FLORIDA

2

Student Full Name * This field is required.

First Name

Middle Name

Last Name

Suffix

3

Date of Birth * This field is required.

Date

4

Parent/Guardian Full Name * This field is required.

Prefix

First Name

Last Name

Suffix

5

Email Address* This field is required.

example@example.com

6

Place of Residence * This field is required.

Street Address

Street Address Line 2

City

State

Zip Code

Country

7

Best Contact Number * This field is required.

Area Code

Phone Number

8

How did you heard about D. Rich Prod performing Arts training program* This field is required.

9

Do you have previous performing arts experience?* This field is required. Ex; dance, music, theatre and musical theatre, illusion, mime, spoken word, circus arts, performance art.

YESNO

10

Registration Fee * This field is required.

My Bag

0

D. Rich Prod Arts- Returning Student
$25.00+Edit
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D. Rich Prod Arts- New StudentD. Rich
$50.00+Edit
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11

Pay with PayPal

First Name

Last Name

Credit Card Number

Security Code

Card Expiration

Please click one of the PayPal options to complete payment and submit the form.

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