Emil Dale Part Time Application Form

Emil dale part time EXTEND Programme AGES 11-21. FREE audition FOR PART-TIME MEMBERS.

NOTHING TO PREPARE. JUST FILL IN THE FORM BELOW
If you have any specific accessibility requirements (such as wheelchair access) or any specific learning needs requirements for your taster day/ audition with us, please email part-time@emildale.co.uk with your requirements and one of the team will contact you to discuss your needs.

Difficulties completing the form? Please call 01462 677 808
Name of Applicant:*

First NameLast Name
Extend is only available to Emil Dale Part-Time members. Please tick here to confirm:*

I am a current Emil Dale Part-Time member
Applicant's Date of Birth (ages 11-21):*

DayMonthYear
Date
Contactable Email Address:*
example@example.com
Contactable Phone Number*
ONE OF THE TEAM WILL BE IN TOUCH TO ARRANGE A FREE AUDITION
Does the applicant have any special access requirements?:*
Emil Dale Part-Time, Emil Dale Academy, Broadway, Letchworth, SG6 3PA
Should be Empty:

Emil dale part time EXTEND Programme AGES 11-21. FREE audition FOR PART-TIME MEMBERS.