BTEC LEVEL 3 APPLICATION FORM

Please complete the form below and email to admissions@asatheatrearts.com along with a headshot
photo attachment.

Please indicate whether you will be submitting a video entry, or whether you would like to
attend a live in-person audition at our studios. Confirmation of your audition date and time
will be emailed to you within 7 days.

APPLICANT DETAILS:

*First Name(s) Adam………………………………………………………………………

*Surname Ellis…………………………………………………………………………….

*Address & Postcode 22 Dulverton Avenue ……………………………………………………………….

CV5 8HF………………………………………………………………………………………….

*Email Address
adamremixes884@gmail.com……………………………………………………………………….

*Phone Number 447871607147………………………………………………………………………

*Date of Birth 28/02/06………………………………………………………………………….

WHICH COURSE ARE YOU APPLYING FOR? (Please tick)

Dance BTEC Level 3

Musical Theatre BTEC Level 3 ✅

WOULD YOU PREFER? (Please tick)

Video Submission Audition

Live In-Person Audition ✅

PARENT/GUARDIAN DETAILS:

*Parent/Guardian Full Name Maxine Ellis………………………………………………………

*Parent/Guardian Phone Number 44 7480 363767…………………………………………………

*Parent/Guardian Email d.ellis743@yahoo.co.uk…………………………………………………………….

*Parent/Guardian Address & Postcode(if different to above) …………………..

………………………………………………………………………………………….

*Full name and address of most recent school/college Coundon Court………………………….

CV6 2AJ…………………………………………………………………………………………..

1. Please list all examinations passed or to be taken (GCSE, AS, A-Level etc) (continue on a separate
page if necessary):
GCSES :
Maths
English language
English literature
Drama
History
Art
Science

2. Please tell us in full about your performing experience (continue on a separate page if necessary):

I attend Pauline Quirke Academy and have been attending since April 2021.

I have recently been in Legally Blonde Junior with PQA and I am going to be playing Khashoggi in We
Will Rock You and will be playing Chad Danforth in High School Musical.

In my old theatre group, we did shows in London.

I also played Jack in jack and the beanstalk a few years ago.

I’ve done dance master classes. We did Jazz, Street and Salsa.

3. Please tell us why you wish to study at ASA Theatre Arts (continue on a separate page if necessary):

I have always wanted to do Musical Theatre as a career and this would a great opportunity to improve
my confidence a bit more and help me achieve my goals for the future. i’ve enjoyed my time doing
Musical Theatre and would love to keep doing it for many years to come.
4. Please detail any SEN requirements for us to assist you at your audition (continue on a separate
page if necessary):

I have extra time for my GCSE exams as I am a slow writer and would not be able to complete an exam
in normal time.

*Please email a headshot (there is no requirement for this to be professional) to

admissions@asatheatrearts.com along with this form.

*Signature of Parent d.ellis………………………………………. Date: 19/06/22

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