PTP - The Admissions Co., Ltd. Registration - Victoria Academy of Ballet

Student InformationStep 1 of 7

PLEASE COMPLETE THIS FORM IN ENGLISH - Thank you!

Student First Name *

*AS IT APPEARS ON YOUR PASSPORT

Student Last Name *

*AS IT APPEARS ON YOUR PASSPORT

Student Preferred Name (if applicable)

*This is the name you want to be called.

Student Gender *

Student Date of Birth *

Student Age *

Student Home Address *

Address Line 1

City

State / Province / Region

Zip / Postal Code

Country

Student Email *

Student Phone *

Academic school the student is currently attending *

Academic grade the student is currently in *

Will you be attending SMS (St. Margaret's) while training at VAB? *

Yes
No
Unsure

Student English Level

Beginner
Intermediate
Upper Intermediate
Advanced

PRIMARY PARENT/GUARDIAN INFORMATION

Primary Parent/Guardian First Name *

Primary Parent/Guardian Last Name *

Primary Parent/Guardian Home Address *

Address Line 1

City

State / Province / Region

Zip / Postal Code

Country

Primary Parent/Guardian Phone *

Primary Parent/Guardian Email *

Primary Parent/Guardian Date of Birth *

SECONDARY PARENT/GUARDIAN INFORMATION

Secondary Parent/Guardian First Name

Secondary Parent/Guardian Last Name

Secondary Parent/Guardian Home Address

Address Line 1

City

State / Province / Region

Zip / Postal Code

Country

Secondary Parent/Guardian Phone

Secondary Parent/Guardian Email

Secondary Parent/Guardian Date of Birth

*The Emergency Contact must NOT be the Primary Parent/Guardian. Please provide another contact.

Emergency Contact First Name *

Emergency Contact Last Name *

Emergency Contact Relationship to Student *

*The Emergency Contact must NOT be the Primary Parent/Guardian.

Emergency Contact Phone *

Emergency Contact Email *

Who should be contacted FIRST in an emergency? *

Primary Parent/Guardian
Secondary Parent/Guardian
Emergency Contact

Who should be contacted SECOND in an emergency? *

Primary Parent/Guardian
Secondary Parent/Guardian
Emergency Contact

Can either parent speak or write English for emergency contact issues?

If yes, which parent?

What is their preference?

Spoken
Written

If not, please provide the name and contact info for an English-speaking emergency contact:

Address Line 1

Address Line 2

City

State / Province / Region

Zip / Postal Code

Country

Phone

Email *

Current Dance School: *

Years of Ballet Training: *

Years of Pointe Work (If Applicable):

Most Recent Ballet Exam Taken:

Other Styles of Dance Training:

Current Dance Syllabus: *

Royal Academy of Dance (RAD)
Vaganova
Cecchetti
Imperial
Don't Know
Other

If 'Other' please describe:

Do you require homestay accommodation provided by VAB? *

I prefer a homestay with another student: *

Yes
No
No Preference

I prefer a homestay with a pet: *

Yes
No
No Preference

I prefer a homestay with a cat: *

Yes
No
No Preference

List your hobbies and interests out of dance: *

Personal Characteristics: *

Active
Social
Easygoing
Quiet/Shy
Anxious
Independent
Prefer Quiet Home

*Please select as many as applicable.

Food Preference, Allergies, and Intolerance: *

Vegetarian
Vegan
Gluten Free
Dairy Free
Other

*Please select as many as applicable.

If 'Other' please describe: *

List any specific food allergies or intolerances if applicable:

Please include any other additional information that will help VAB select an appropriate host family:

Please note any special concerns about your homestay accomodation:

Canadians often participate in outdoor activities in or around the water. Please rank your swimming level below.

Non-Swimmer
Beginner
Intermediate
Advanced

Following registration, students will receive a Medical History Form that will require further detail about their physical and mental health.

Do you have any medically diagnosed allergies? *

If 'Yes', please describe: *

Are you experiencing any major, on-going injuries? *

If 'Yes', please describe: *

Please describe any major health concerns:

Give a full description of the any health issue that required medical attention in the last two years:

*Including diagnosis of eating disorders and/or counseling

List any supplements or prescription medications that you take on regular basis, and what they are treating:

NOTE: Students bringing prescription medication must provide a translated copy of the prescription.

I have read and agree to the Refund Policy detailed in the Program Manual for the Professional Training Program. *

Yes (I Agree)

I understand and agree that fees for Summer Programs are non-refundable. For clarity, this includes the Professional Dance Intensive. *

Yes (I Agree)

I have read and agree to the Homestay Refund Policy detailed in the Program Manual for the Professional Training Program. *

Yes (I Agree)

I have read and agree to the tuition rates for the Professional Training Program. *

Yes (I agree)

Date of Agreements *

Phone

Academy

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Summer Programs

Professional Dance Intensive 12+ (3 weeks, by audition)
Summer Dance Intensive 12+ (2 weeks)
Junior Dance Intensives 7-12 yrs
Storybook Summer Camps 4-6 yrs

PTP – The Admissions Co., Ltd. Registration

PLEASE COMPLETE THIS FORM IN ENGLISH - Thank you!

PRIMARY PARENT/GUARDIAN INFORMATION

SECONDARY PARENT/GUARDIAN INFORMATION

*The Emergency Contact must NOT be the Primary Parent/Guardian. Please provide another contact.

Following registration, students will receive a Medical History Form that will require further detail about their physical and mental health.

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