Wingate Stage Academy Application

Thank you for choosing to book a place at Wingate Stage Academy.

Please use the form below to submit your details. If you have any questions please contact us on 01325 262719 (24 answer phone). We will contact you as soon as possible to confirm your booking details. Your place will be confirmed when your deposit has been paid.

By registering your details you will automatically be signed up to our mailing list and will receive information about future opportunities with Wingate Stage Academy and Melting Pot Arts. Please contact us if you wish to stop receiving information at any point in the future.

Your information will only be used by Melting Pot Arts and not passed onto any third party. We will use your details to contact you with information relating to your answers. Your information will be kept for an indefinite period of time and stored in accordance with our Data Protection Policy.

Please register the details of the person who wishes to join the project.

All members must be registered separately.

Contact Details

Name
Address	House Number & Street
	Town
	County
Post Code
Email *	Our main contact with you will be via email, please ensure this address is correct and checked regularly
Home Tel
Mobile

If you are registering an adult (18+) please tick here:

If you are registering someone aged 18 or under please include the following details:

Date of Birth		Age
School / College (if applicable) **		Year Group **

** Please tell us which school and year group you will be in from September 2008.