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Course NameStart DateEnd DateSite
Emerging Talent - Autumn21/09/202523/11/2025Italia Conti

Personal Details


Title
First Name
Surname
Date Of Birth

Sex



Contact Details

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

Postcode

Mobile
Personal Email Address
Personal Email Address (enter again)
     
How did you hear about us?

Emergency Contacts



Contact 1

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

Contact 2 - for Under 18's, you must enter a second contact

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
Current Performing Arts school
T shirt size

If you're attending an event, How many people (including yourself) will be attending

Performance experience

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
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



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 here
  • I have read and agree to the Privacy policy here
  • I have read and agree to the study location information
  • Additional support is available to me if needed
  • I have read and agree to the Privacy policy in relation to GDPR here

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

Signature

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