PENINSULA TECHNIKON SYMPHONY WAY BELLVILLE TEL: 9596041
FAX:9596783
: MalanE@pentech.ac.za
| Student’s Name | |
| Student’s Surname | |
| Date of Birth (DD/MM/YYYY) | |
| Name of Parent/ Guardian | |
| Address |
| Street | |
| Area | |
| City | |
| Phone |
| School | |
| Previous dance training. Please list number of years And schools of previous Training. |
EMERGENCY INFORMATION
| Doctor’s Name | |
| Doctor’s Phone | |
| Medical Alerts/Special needs |
Please indicate which courses you will be attending.
Classical Ballet |
Modern | Hip-Hop |
| Breakdancing | Freedancing | Spanish |
| Mapantsula | Gumboots | Ballroom |
| Coaching | Dance-Theatre | Make-up |