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* 1. Full name

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* 2. Date of birth

Date / Time

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* 3. Age on August 1st 2017

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* 4. Gender

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* 5. Address

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* 6. Contact email

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* 7. Contact telephone number

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* 8. Please provide the name and contact tel for someone in case of emergency (plus their relationship to you)

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* 9. Do you have any access requirements? (please give details)

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* 10. Please tell us a little bit about your previous artistic experiences in dance, theatre & physical theatre

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