NXT GEN SIGN UP FORM

NXT GEN PERSONAL DETAILS FORM
(Please complete all sections of this form)
What you are looking to study Option 1:*
What you are looking to study Option 2:*
If you've selected 'Music Performance', please let us know which instrument you are interested in:
DRUMS/BASS/GUITAR/KEYS/VOCALS
YOUR DETAILS
Name*

ForenamesFamily Name
Date of Birth*

MonthDayYear
Date
Current age*
Mobile Number*

Area CodePhone Number
Home Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact Email Address*
example@example.com
NEXT OF KIN DETAILS (Parent/Guardian/Carer)
Name*

ForenamesFamily Name
Mobile Number*

Area CodePhone Number
Relationship to applicant*
Email Address*
example@example.com
THINGS TO HELP US HELP YOU
Do you consider yourself to have a disability/learning difference? If yes, please give details.*
Are you able to leave the building unattended after the session? *
Do you consent to photos and videos being taken and used on NXT GEN or BN1 ARTS marketing materials?*

YesNo
BN1 ARTS LIMITED is the Data Controller for the personal data you disclose via this form. The information you have provided will be stored on file and included in any offer/contract you receive from BN1 ARTS LIMITED and BN1 ARTS CENTRE CIC
Please tick this box to confirm you are happy for this information to be sent to you by e-mail.*

YES
Please confirm if you will be paying monthly or termly*

MonthlyTermly
I confirm that the information provided on this form is accurate to the best of my knowledge:*

YES
Date*

MonthDayYear
Date
Signed and Dated (Parent/ Guardian if under 18)*

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NXT GEN PERSONAL DETAILS FORM

YOUR DETAILS

NEXT OF KIN DETAILS (Parent/Guardian/Carer)

THINGS TO HELP US HELP YOU