Registration Application (Copy) — New York Teen Shakespeare Intensive

STAGE STRUCK REGISTRATION APPLICATION

Applicant's Name

First Name

Last Name

Birthdate

MM

DD

YYYY

School Attending in the Fall 2024

Current Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

Country

(###)

###

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Email Address

Please list previous acting experience (if any) such as other programs, school plays, etc...

Parent/Guardian 1 - Name

First Name

Last Name

Parent/Guardian 1 - Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent/Guardian 1 - Phone

Country

(###)

###

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Parent/Guardian 1 - Email

Parent/Guardian 2 - Name

First Name

Last Name

Parent/Guardian 2 - Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent/Guardian 2 - Phone

Country

(###)

###

####

Parent/Guardian 2 - Email

Additional Comments