• 1. Personal Details

    Please share some basic information about you.
  • Date of birth.*
     - -

  • You must be aged 16, 17 or 18 on 31st of August 2025
    (unless you have an EHCP in which case you must be 16-24)


  • 2. Emergency Contacts

  • Emergency Contact 1

  • Relationship to you*
  • Do you give us permission to contact your parent/carer once (if) you are 18?*

  • Emergency Contact 2

  • Relationship to you
  • Do you give us permission to contact your parent/carer once (if) you are 18?

  • 3. Learning, disability or mental health needs

  • Do you have a physical disability*
  • Do you have any medical needs?*
  • Do you have any mental health issues?*
  • Do you have a mental health diagnosis?*
  •  Do you have any medical needs that might affect you while at college?*
  • Do you take any medication?*
  • Do you need to take medication during college hours?*

  • 3. Tell us why you should be shortlisted for Academy Breakin' Convention

  • You can submit your response to the next question in either of the following formats:

    Type or copy into the box below a written response (up to 150 words)
    Upload an audio or video recording (duration of 2-3 minutes)

    What do you hope to develop at Academy Breakin' Convention?

  • Select how you would prefer to answer this question*
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