APPLICATION

The Elite Academy of Performing Arts Student Application Form

Student Information

Full Name: ________________________________
Date of Birth: __________ Age: ____
Current School: ____________________________
Programs of Interest: Dance, Theater/Acting, Vocal/Music, Musical Theatre, Visual Arts, Other

Parent/Guardian Information

Name(s): _________________________________ Phone: _________________________________ Email: _________________________________ Address: _______________________________

Emergency Contact

Name: _________________________________ Relationship: __________________________ Phone: _________________________________

Student Background

Has your child participated in performing arts before? Yes / No
If yes, explain: __________________________________________ Student strengths or talents: ______________________________

Educational Accommodations & Learning Needs

Does your child have: IEP, 504 Plan, Gifted Plan, Speech Services, OT, Behavioral Plan, None Describe supports/accommodations: __________________________
Supports used: Extended time, Small group, Sensory breaks, Assistive tech, Other

Health & Safety Information

Allergies/Medical Conditions: ______________________________ Medications: _____________________________________________

Parent Statement

Why do you want your child to attend our school? _________________________________________________________ Goals for your child this year: _________________________________________________________

Required Documents

Birth Certificate, Immunization Records, Report Card, Student Photo (optional), IEP/504 (if applicable)

Application Fee

Application Fee: $______ (Non-refundable) Payment Method: Cash, Check, Online, Other

Signature

Parent/Guardian Signature: ______________________ Date: _______