Student Information
Student Name
*
First Name
Middle Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Age on a date of audition
*
Contact Information
Student e-mail address
*
Student phone number
-
Area Code
Phone Number
Parent/Guardian Name
*
First Name
Middle Name
Last Name
Parent/Guardian e-mail address
*
Parent/Guardian phone number
*
-
Area Code
Phone Number
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Additional Information
Current ballet school
*
Current ballet teacher
*
Number of years studying ballet/dance
*
Number of years on pointe
Audition for
*
Summer Intensive
Pre-professional training
Both
How did you hear about Illinois Classical Ballet
*
Teacher/school recommendation (please provide name below)
Student/dancer recommendation (please provide name below)
Facebook
Instagram
Other social media/website (please provide name below)
Other
Electronic Signature Agreement
*
I Agree
Audition
*
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Audition
$
40.00
In-person audition
Quantity
1
2
3
4
5
6
7
8
9
10
Total
$
0.00
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