New World Theatre Club

Application

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Please enrol me as*:

day student (fee 550 ?, deposit 250 ?)
residential student (fee 750 ?, deposit 300 ?)

First Name:

Last Name*:

Date of Birth*:

Nationality*:

Gender*:

MaleFemale

Street Address*:

City*:

Province:

Postal Code*:

E-Mail*:

Home Phone:

Mobile Phone:

Fax:

Project Prefrences*:

I am interested in the Skills directing project
I am interested in a music (singing) project
I am interested in directing in Project 3

Special Requirements:

Please note that I wish to take vegetarian meals (fish instead of meat)
I would like a single room, if available, at a supplement of ?80 for the week

Please indicate any other special needs (vegan, gluten free diet, mobility, etc.):

I would like to share a room with ::

I will send my letter of application for an NWTC scholarship, to attend at the special reduced fee of 275 ?, together with letter of reference to Nola Dutton.*:

yesno

Verification:

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The deposit is payable by 31 May to : New World Theatre Club IBAN LU80 0030 0960 1115 0000 Fortis Bank Luxembourg BGLLLULL

For fairness and to minimise disappointment we shall need firm commitment from all applicants as soon as possible ; for this reason please note that €50 of the deposit will be withheld if you withdraw after 30th June ; the deposit in full will be forfeited if you withdraw after 15th July.

Applications Coordinator : Nola Dutton, 22 South Parade, Northallerton, N. Yorkshire, DL7 8SG, England tel : +44 (0) 1609 773 500 ; e-mail:Nola(at)DuttonsOnline(dot)co(dot)uk

Treasurer: Chris Albrecht, 18 rue Haart, L-5415 Canach, Luxembourg tel : +352 358 280 ; e-mail:christopher(dot)albrecht(at)pt(dot)lu

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