Summer Animation Academy
Nerve Centre Belfast
Name
First Name
Last Name
Date of Birth (day/month/year)
Age
Gender
Male
Female
Prefer not to say
Other
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Email (please do not use a c2k email address)
example@example.com
School Year for 23/24
Name of School/College
Tell us more about your experience with Animation
Have you previously attended a workshop with the Nerve Centre
Where did you hear about this summer school
Social Media
School Visit
Teacher / Tutor
Parent / Guardian
Newsletter
Other
I give permission to have my photo/video taken to be used by the Nerve Centre for celebration or promotional purposes.
Yes I agree
No I do not agree
I am under 18 and my parent/guardian gives permission (to be confirmed via email below)
If under 18 please provide an email address for a Parent/ Guardian.
Terms and Conditions
I hereby confirm that the information I have given in this application is true and correct
I confirm my availability for the Summer School (24th - 28th July, 10am-4pm)
I agree that Nerve Centre may, for administrative purposes only, make copies of any material submitted in support of my application.
By submitting this form, I understand that, Nerve Centre will store and process data in accordance with professional standards and data protection legislation.
If under 18 I confirm that my parent or guardian has given me permission to apply to the Summer School
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