New Student Application – Acting In St. Augustine

Thank you for considering Acting In St. Augustine. We are excited to learn more about you and how we can work together to help you with your acting education.

How did you learn about Acting In St. Augustine? *

I am interested in: *

Private Lessons
Group Lessons
Virtual Lessons

Name *

First

Last

Parent or Guardian Name *

First

Last

If student is under 18, please provide parent or guardian information. If student is 18 or older, please type N/A in both fields.

Address, City, ST, Zip

Student Best Phone Number (N/A if none)

Student Email *

Confirm Email

You will be sent an email to confirm your email address from our system.

Parent Best Phone Number (N/A if none)

Parent Email

Confirm Email

You will be sent an email to confirm your email address from our system.

Age

For age appropriate training

Gender

Male
Female
I prefer not to disclose

If student is under 18, this will require a signature (Please print and sign).

Emergency Contact Name *

First

Last

Emergency Phone *

We will call and text.

Emergency Contact Relationship *

Please list any allergies or accommodation needs.

Please type N/A if none.

Acting Experience and Goals *

Tell me about your experience if any, why you want to take this class and what is your goal in taking this class?

My expected ongoing payment method will be:

Credit Card
Check
Cash

I understand classes are paid in advance and there will be a convenience fee added for credit card payments and there is a $25.00 returned check fee for a check returned by your bank.

Student/Parent/Guardian Name *

First

Last

For students under 19, the parent or guardian must print and sign this application.

Date Application Signed *

Please enter date in MM/DD/YYYY format.

Name

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