Personal Information

First Name:*
Last Name:*
Date of Birth:
Place of Birth:
Country of Citizenship:
Province / State:*
Postal / ZipCode:*
Program of Interest:*
Expected Start Date:*
English Language Requirements:

Secondary Education

Name of High School:*
Location of High School:*
Graduation Date / Expected Graduation Date:*

Post-Secondary Education

Name of College / University attended (if applicable):
Location of College / University attended:
Area of study at College / University:
College / University Diploma or Degree obtained:


Have you auditioned for us before? If so, when?
How did you hear about us?
Please Specify:

In Case of Emergency Contact

Emergency Contact Name:*
Emergency Contact Telephone:*
Emergency Contact Relationship:*

Consent to Receive Commercial Electronic Messages

By submitting this form, I agree that Randolph College for the Performing Arts may call, text and/or email me about their educational services at the contact information provided, including a wireless number, using automated technology. Please note, this consent is not required to attend their institutions and you may unsubscribe at any time.