Apply Now Application Form Thank you for applying to Addict Dance Academy. Please complete all sections of this form and select SUBMIT when you are finished. PLEASE SELECT THE COURSE YOU WISH TO APPLY FORPERSONAL DETAILSPLEASE SELECT THE COURSE YOU WISH TO APPLY FOR BTEC EXTENDED DIPLOMA IN PERFORMING ARTS (DANCE) (LEVEL 3) BTEC EXTENDED DIPLOMA IN PERFORMING ARTS (MUSICAL THEATRE) (LEVEL 3) BTEC HIGHER NATIONAL DIPLOMA IN PERFORMING ARTS (DANCE) (LEVEL 4+5) BTEC HIGHER NATIONAL DIPLOMA IN PERFORMING ARTS (MUSICAL THEATRE) (LEVEL 4+5) NEW BA HONS DANCE (LEVEL 6) TOP UPTITLE Mr Mrs Miss OtherFORENAME SURNAME/FAMILY NAME DATE OF BIRTH Do you know your National Insurance Number? Yes NoNATIONAL INSURANCE NUMBER PERMANENT ADDRESSAddressAddress Line 1 Address Line 2 City County Post Code Country Select CountryAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelauBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo (Brazzaville)Congo (Kinshasa)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSão Tomé and PríncipeSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (Dutch part)Saint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom (UK)United States (US)United States (US) Minor Outlying IslandsUnited States (US) Virgin IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabweDo you live at a different address during term time? Yes NoAddressAddress Line 1 Address Line 2 City County Post Code Country Select CountryAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelauBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo (Brazzaville)Congo (Kinshasa)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSão Tomé and PríncipeSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (Dutch part)Saint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom (UK)United States (US)United States (US) Minor Outlying IslandsUnited States (US) Virgin IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabweHOME TELEPHONE MOBILE TELEPHONE EMAIL ADDRESS ETHNICITYI would describe my ethnic origin as: ENGLISH/SCOTTISH/WELSH/ NORTHERN IRISH/BRITISH IRISH GYPSY OR IRISH TRAVELLER OTHER WHITE BACKGROUND INDIAN PAKISTANI BANGLADESHI CHINESE OTHER MIXED BACKGROUND WHITE AND BLACK CARIBBEAN WHITE AND BLACK AFRICAN WHITE AND ASIAN OTHER MIXED BACKGROUND AFRICAN CARIBBEAN OTHER BLACK/AFRICAN/CARIBBEAN BACKGROUND ARAB ANY OTHER ETHNIC BACKGROUND UNKNOWN/NOT PROVIDEDDISABILITY OR LEARNING DIFFICULTIESDO YOU HAVE A DISABILITY? Yes NoDISABILITY MULTIPLE DISABILITIES BLIND OR VISUALLY IMPAIRED (little or no sight) DEAF OR HEARING IMPAIRED (use a hearing aid or sign language DISABILITY AFFECTING MOBILITY (e.g. wheelchair user) EMOTIONAL/BEHAVIORAL DIFFICULTIES MENTAL HEALTH DIFFICULTY (please state) TEMPORARY DISABILITY OR ILLNESS (e.g. accident) PROFOUND COMPLEX DIFFICULTY ASPERGERS SYNDROME OTHER PHYSICAL DISABILITY OTHER MEDICAL CONDITION (e.g. epilepsy, asthma, diabetes) OTHER (please state)OTHER DO YOU HAVE A LEARNING DIFFICULTY? Yes NoLEARNING DIFFICULTY MODERATE LEARNING DIFFICULTY SEVERE LEARNING DIFFICULTY DYSLEXIA (difficulty with words) DYSCALCULIA (difficulty with numbers) AUTISM SPECRTUM DISORDER OTHER SPECIFIC LEARNING DIFFICULTY (please state) OTHER (please state)OTHER DO YOU NEED ANY SUPPORT AT INTERVIEW STAGE? Yes NoIf YES please give details DO YOU HAVE A STATEMENT OF SPECIAL EDUCATION NEEDS? Yes NoIf YES please give details ADDITIONAL DETAILSDO YOU HAVE ANY UNSPENT CRIMINAL CONVICTIONS, INCLUDING INTENSIVE SUPERVISION AND SURVEILLANCE PROGRAMME (ISSP) OR DRUG TREATMENT AND TESTING ORDER (DTTO)? Yes NoPLEASE GIVE THE NAME OF THE LAST SCHOOL OR COLLEGE YOU ATTENDED OR ARE STILL ATTENDING NAME OF EMERGENCY CONTACT EMERGENCY CONTACT NUMBER PreviousNext PagePERSONAL STATEMENTPlease complete the following questions:WHY DO YOU WANT TO STUDY THIS COURSE? HOW DO YOU THINK THIS COURSE WILL HELP YOU IN YOUR FUTURE PLANS OF EMPLOYMENT/EDUCATION? DO YOU HAVE ANY PERFORMANCE EXPERIENCE? ARE YOU CURRENTLY STUDYING ANY QUALIFICATIONS YOU ARE YET TO RECEIVE GRADES FOR? Yes NoHOW MANY QUALIFICATIONS ARE YOU CURRENTLY STUDYING? - Select -1234567891010+Examining Board e.g. Edecel Subject e.g. Maths Level e.g. GCSE Predicted Grade Date to be taken Length of Study (Years) Examining Board e.g. Edecel Subject e.g. Maths Level e.g. GCSE Predicted Grade Date to be taken Length of Study (Years) Examining Board e.g. Edecel Subject e.g. Maths Level e.g. GCSE Predicted Grade Date to be taken Length of Study (Years) Examining Board e.g. Edecel Subject e.g. Maths Level e.g. GCSE Predicted Grade Date to be taken Length of Study (Years) Examining Board e.g. Edecel Subject e.g. Maths Level e.g. GCSE Predicted Grade Date to be taken Length of Study (Years) Examining Board e.g. Edecel Subject e.g. Maths Level e.g. GCSE Predicted Grade Date to be taken Length of Study (Years) Examining Board e.g. Edecel Subject e.g. Maths Level e.g. GCSE Predicted Grade Date to be taken Length of Study (Years) Examining Board e.g. Edecel Subject e.g. Maths Level e.g. GCSE Predicted Grade Date to be taken Length of Study (Years) Examining Board e.g. Edecel Subject e.g. Maths Level e.g. GCSE Predicted Grade Date to be taken Length of Study (Years) Examining Board e.g. Edecel Subject e.g. Maths Level e.g. GCSE Predicted Grade Date to be taken Length of Study (Years) Please add details of the remaining qualifications you are currently studying TELL US ABOUT YOUR PREVIOUS QUALIFICATIONS (FOUNDATION DEGREE’S, HND’S, GCSE’S, A-LEVELS, BTECS ETC)HOW MANY PREVIOUS QUALIFICATIONS DO YOU HAVE? - Select -1234567891010+Examining Board e.g. Edecel Subject e.g. Maths Level e.g. GCSE Grade Achieved Date taken Length of Study (Years) Examining Board e.g. Edecel Subject e.g. Maths Level e.g. GCSE Grade Achieved Date taken Length of Study (Years) Examining Board e.g. Edecel Subject e.g. Maths Level e.g. GCSE Grade Achieved Date taken Length of Study (Years) Examining Board e.g. Edecel Subject e.g. Maths Level e.g. GCSE Grade Achieved Date taken Length of Study (Years) Examining Board e.g. Edecel Subject e.g. Maths Level e.g. GCSE Grade Achieved Date taken Length of Study (Years) Examining Board e.g. Edecel Subject e.g. Maths Level e.g. GCSE Grade Achieved Date taken Length of Study (Years) Examining Board e.g. Edecel Subject e.g. Maths Level e.g. GCSE Grade Achieved Date taken Length of Study (Years) Examining Board e.g. Edecel Subject e.g. Maths Level e.g. GCSE Grade Achieved Date taken Length of Study (Years) Examining Board e.g. Edecel Subject e.g. Maths Level e.g. GCSE Grade Achieved Date taken Length of Study (Years) Examining Board e.g. Edecel Subject e.g. Maths Level e.g. GCSE Grade Achieved Date taken Length of Study (Years) Please add details of the remaining qualifications you have completed WHERE DID YOU HEAR ABOUT US? - Select -Social MediaFriend/Current StudentMove ItOther I consent to have Addict Dance Academy store my submitted information so they can respond to my application I have read and agree to the Terms and Conditions and Privacy Policy Previous SUBMIT APPLICATION
