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RSP-DAN-VAR-P33-100, Dance Associate Programme - Term 3, 22/23

Please complete the below form to signup to the Dance Associates Programme.

A charge of will be requested via an online form following the completion of this form. Only complete this form if you are able to pay this at this time. If you require financial support or have any questions please email pendletondance@salfordcc.ac.uk for further information.

Personal Details
Student Reference ID: (If Applicable)
First Forename
Preferred Name
Surname
Date Of Birth
Tel
Email
Email (enter again)
     
Address Details
House No/Name and Street
Town
County

eg WF7 9EH
Emergency Contact Details - Parent/Guardian 1
Parent First Name
Parent Surname
Parent Title
Parent Mobile Tel
Parent Phone Number
Parent Email Address
Is Living With Parent
Emergency Contact Details - Parent/Guardian 2
Parent2 First Name
Parent2 Surname
Parent2 Title
Parent2 Phone Number
Parent2 Email Address
Parent2 Mobile Tel
Is Living With Parent2
Additional Information
Current High School
Current Dance School or training (if applicable)
Please give a brief outline of previous Dance experience/interest in Dance:
Please outline any health or medical conditions that will be relevant to participation and if req, outline of any medication or adaptations that will need to be available
e.g. Inhalers/access requirements:
Please notify us of any ongoing injuries to enable us to ensure safe practice through modifications of delivery. If injuries are under the advice of a physiotherapist (for example) please outline recommendations here:
How did you hear about the Associate Programme?
Voucher Code
Declaration & Photo Consent
Please take time to read through this declaration before proceeding

Consent is given for the named person above to be filmed and/or photographed and this media to be shared on Social Media and/or Marketing for the College.

The college will process the information provided in this form for the purposes of progressing your application or for education, training and administration purposes. Information will be processed in accordance with the college’s data protection policy. For more information about how we manage your personal data and your individual rights please visit the College’s website.

By signing this form, you confirm the information you have provided is accurate to the best of your knowledge and that you understand the information set out in this Privacy Notice.

If I am accepted on the course(s) for which I am now applying, I agree to observe all campus regulations. I understand that College will store the information on this form and other information while attending the College/LZ6 subject to the provisions of the Data Protection Act 1998 and the registration of the College under the Act.