| PERSONAL DETAILS |
| Family Name:* |
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| First Names:* |
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| Preferred First Name:* |
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| Email Address:* |
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| Home Address:* |
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Postal Address:
(if different from above) |
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| Telephone: |
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| Home:* |
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| Business: |
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| Mobile: |
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| Gender: |
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| Birth Date:* |
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| Age:* |
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| Marital Status: |
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Citizenship and Residency:
(select that which best describes your citizenship or permanent residency status) |
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If other, please specify:
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| COURSE SELECTION |
| Programme applying for |
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| Certificate of Performance in Music major: |
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It is not compulsory to choose a minor subject, although you may wish to. Minor subjects are taken in addition to your major and are taught at a slower pace. The subjects available to be taken as minors are listed below. You must audition for both your major and minor subjects. Please tick the one you wish to audition for.
(you can tick more than one) |
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| EDUCATION DETAILS |
What was your last year at secondary school?
(e.g. 2004) |
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Level:
(e.g. Year 12) |
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Do you have NCEA Level 1 English:
(or equivalent) |
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What is the highest secondary school qualification you have attained?
(Tick only one box) |
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| How did you hear about EXCEL? |
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| LEGAL |
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| Have you ever been convicted of a criminal offence? |
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If “Yes”, Please give details:
(the information you supply will remain confidential) |
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| STUDY LINK |
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| Are you intending to apply for a LOAN from Study Link to pay for the course? |
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| MEDICAL |
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| Are you on any form of medication at present? |
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| If “Yes”, please give details: |
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| CHRISTIAN EXPERIENCE |
| Do you consider yourself to be a Christian? |
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| If “Yes”, for how long? |
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Which church do you attend:
(If applicable) |
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| If you are able, describe your personal relationship with the Lord: |
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| ARTS TRAINING |
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| What experience or qualifications do you have in any of the following areas: Music, drama, singing, dancing, sound, lighting. |
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| REFERENCE |
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| We require one recent character reference from any of the following leaders: Pastor, Teacher, Church Elder, Maori Elder, Youth Pastor, Employer, Community Leader. You will need to use the official EXCEL reference form. Please give the reference form to the person you have nominated and ask them to mail it directly to the EXCEL school office. |
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| DECLARATION |
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