Performing Spaces Arts Institute Form

PERFORMING SPACES ARTS INSTITUTE

REGISTRATION FORM FOR FALL TERM 1 - OCTOBER 18 - DECEMBER 22, 2025
NAME OF APPLICANT*

First NameLast Name
DATE OF BIRTH*

MonthDayYear
Date
AGE*
MaleFemale
MOBILE NUMBER*
Format: (000) 000-0000.
HOME NUMBER
Format: (000) 000-0000.
EMAIL*
example@example.com
HOME ADDRESS
WHICH SCHOOL DO YOU ATTEND? (IF APPLICABLE)
PLACE OF EMPLOYMENT (IF APPLICABLE)
DANCEVOCAL TRAININGACTINGAERIAL ARTS
BeginnerIntermediateAdvanced
DOES THE APPLICANT HAVE ANY MEDICAL CONDITIONS WE SHOULD BE AWARE OF?
NAME OF PARENT/GUARDIAN (IF APPLICABLE)

First NameLast Name
MOBILE NUMBER OF PARENT/GUARDIAN (IF APPLICABLE)
Format: (000) 000-0000.
HOME NUMBER OF PARENT/GUARDIAN (IF APPLICABLE)
Format: (000) 000-0000.
EMAIL OF PARENT/GUARDIAN (IF APPLICABLE)*
example@example.com
SIGNATURE OF APPLICANT OR PARENT/GUARDIAN
Should be Empty:

PERFORMING SPACES ARTS INSTITUTE