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Course NameStart DateEnd DateSite
MT - Boys Day12/01/202512/01/2025Italia Conti

Personal Details


Title
First Name
Surname
Date Of Birth

Gender at Birth

Gender Identity


First Language

Contact Details

House No./Name and street (Address Line 1)
Address Line 2
Town / City
County

Postcode

Contact Number (Home Telephone)
Mobile
Personal Email Address
Personal Email Address (enter again)
     
How did you hear about us?
Have you previously attended a course with Italia Conti?
If so which have you attended?
What year did you audition?

Photo

Upload Photo - A headshot photograph for your student record


4MB Maximum file size, only jpg, png, jpeg and gif files are accepted


Click 'preview' to view a preview of your photo - if you are happy then click 'Upload' below the photo, otherwise you can cancel and upload another

Please ensure your photo is oriented the correct way round


Emergency Contacts



Contact 1

Emergency Contact Name
Emergency Contact Relationship
Emergency Contact Phone number
Emergency Contact Email Address

Contact 2

Emergency Contact Name
Emergency Contact Relationship
Emergency Contact Phone number
Emergency Contact Email Address

Have you attended an Italia Conti Associate school?
If yes - which school
Performing Arts Education / Performance Experience:
Current School
Performance experience including any Performing Arts Schools or training courses attended

Equal Opportunities

The following information is only used to monitor applications to the academy and supply information for Government and Educational statistics. It is not used as part of the audition process

Ethnic Group
What is your country of residence?
Nationality
Do you have any disabilities or learning difficulties?
Primary Disability/Learning Difficulty
Secondary Disability/Learning Difficulty

Please provide any extra information that can help us to help you

Notes



Terms & Conditions / Privacy Policy


Plase tick below if you would like to be contacted by Italia Conti regarding upcoming shows, events and other opportunities.


Please tick the box below to confirm:

  • I have read and agree to the Terms & Conditions (Summer School) (Conti Camp)
  • I have read and agree to the Privacy policy here
  • Additional support is available to me if needed
  • I accept the Conditions of Enrolment
  • I give my consent for any photography or filming undertaken by Italia Conti during the course
  • I Consent to Italia Conti using my personal information in accordance with its data protection policy. here

Digital signature (Applicant’s signature or parent/guardian if the applicant is under 18 years of age)

Signature

Clear Signature