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WESTSIDE STAGE SCHOOL APPLICATION FORM
First Name
Surame
Date of Birth
.
Male
Female
Address
email address****REQUIRED*****
Home Phone
Parent / Guardian Name(1)
Parent/Guardian Mobile(1)
Parent / Guardian Name(2)
Parent/Guardian Mobile(2)
Day you wish to attend classes
Monday (Age 4 - 12) Lucan Village
Monday (Age 4 -12) Griffeen
Wednesday (Age 4 - 12) Griffeen
Friday (Age 4 - 12) Lucan Village
Saturday Morning (Age 4 - 12) Griffeen
Saturday Afternoon (Age 4- 12) Griffeen
Monday Night (Age 12+) Griffeen
Tuesday Night (Age 12+) Griffeen
Wednesday Night (Age 12+) Griffeen
If the session you have applied for is full, do you wish to
Remain on waiting list for chosen session
Interested in availability in other sessions
Details of any Medical Condition, Special Needs or any other details that we should be aware of. IF NONE PLEASE STATE SO
Please list any related experience / training(singing, dance, drama etc) and any particular talents
How did you hear about WestSide
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