THE ACADEMY OF CIRCUS ARTS CIRCUS HEADQUARTERS, ENBORNE, NEWBURY RG20 0LD APPLICATION FORM IMPORTANT: Please complete using BLOCK CAPITALS and attach a recent photo Personal details NAME AGE ADDRESS DATE OF BIRTH Email address HomeTelephone No. MobileTelephone No Nationality Previous Education Name & Address of school or college attended Year & dates Subjects studied & qualifications achieved Please give details of any other training or qualifications: Previous employment (if any): Name & address of employer Year & dates Job title & type of work Do you hold a Driving Licence? (YES/NO) Will you provide your own transport and/or accommodation on tour? (YES/NO) If yes, please give details Have you had any previous experience in any of the following areas? Theatre Skills (e.g. Acting, Mime, Clowning, Physical Theatre etc.) (YES/NO) Dance (e.g. Ballet, Tap, Jazz, Modern, etc.) (YES/NO) Music (e.g. Singing or playing an instrument) (YES/NO) Related Sports (e.g. Gymnastics, Acrobatics, Trampolining, Climbing etc) (YES/NO) Circus Skills (YES/NO) Technical Skills (e.g. Stage management, Lighting or Sound operation, Dressmaking, Carpentry, Welding, Engineering etc) (YES/NO) Administration (in general, in relation to performance arts) (YES/NO) Please give details of above skills attained: Skill Level of competence Place where gained experience/training Have you performed this skill in a professional capacity (YES/NO) Please state any other hobbies or interests: How did you find out about our training and performing Course? If it was through an advertisement, where did you see it advertised What attracted you to apply for our training and performing Course? What will you like to achieve by the end of the Course? What kind of employment will you hope to secure at the end of the course and how do you hope to use the skills you gave gained? If there is an opportunity would you like to perform a short audition piece (not more that 5 minutes long) (YES/NO) If you are unable to attend an interview/audition, will you send a video of yourself (YES/NO) Is there any reason why you might not be available for the full 2009 Course (YES/NO) I declare the information have given is correct Signature Date