Midland Theatre Ballet Application Form

MTB Saturday Associates Audition Application Form 2024/25

Midland Theatre Ballet - Saturday Associates 2024/25
Applicant Information
Applicant Name*

First NameLast Name
Address:*

Street Address

Street Address Line 2

CityState / Province

Postcode
Date of Birth*
DD/MM/YYYY
Current Age (on 13th July 2024)*
Email Address (Parent/Guardian or 18+ Student)*
Confirm above Email Address*
Mobile Number (Parent/Guardian or 18+ Student)*
Home Telephone Number*
Upload candidate headshot for ID purposes*

Cancelof
Ballet Information
Last Exam Taken
Date Taken

DayMonthYear
Date
Result of Exam
Syllabus (e.g RAD/IDTA)
Do you study Pointe?*

YesNo
If yes, how long for?
How many hours do you dance per week (approx)?
Dance School
Name of Dance School*
Name of Principle*
All students must have full permission and support from their Dance Teacher to join Midland Theatre Ballet. Please do not complete this form unless you have spoken to your Dance Teacher.*

I confirm that I have full permission and support from my Dance Teacher to apply for this programme.
Audition Information
I acknowledge that an audition fee is due prior to the audition taking place*

Yes, I acknowledge that there is a non-refundable audition fee.
I understand and agree that MTB photographers may take photos of students during rehearsals and auditions and MTB may use them for promotion purposes online.*

Yes, I acknowledge, agree and understand this.
Can your child leave the studios unaccompanied after the audition?*

Yes, I give my permission.No, I do not give my permission.
Medical Information
Is there any medical information/allergies that we need to know about? Do you require any emergency medication (e.g. EpiPens / Inhalers)?*
If an emergency occurs I/we give permission for a Midland Theatre Ballet representative to take the applicant to hospital*

Yes, I give my permission.
Emergency Contact Name (For Audition Day)*

First NameLast Name
Emergency Contact Phone Number (For Audition Day)*
2nd Emergency Contact Name (For Audition Day)*

First NameLast Name
2nd Emergency Contact Phone Number (For Audition Day)*
Privacy Policy
Please read our Privacy Policy in order to understand how your information is used and shared, and check below if you accept the policy.*

I have read, understood, and accepted the privacy policy for MTB.
Please list any further comments/questions that you would like to add to your application.
Parent Signature / or Student 18+ Signature*

Clear

My Products*

£30 Audition FeeNon-refundable.

£30.00 Quantity

Enter coupon

Total

£0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Once you submit your application, you will receive a confirmation email to confirm your audition time within 7 working days.
Should be Empty:

MTB Saturday Associates Audition Application Form 2024/25

Applicant Information

Ballet Information

Dance School

Audition Information

Medical Information

Privacy Policy