| SPBA School Year: Application Form |
| The Very Best in Ballet Training |
|
Printer Friendly Page: Please, (a) print it, (b) fill it out, (c) sign it, and (d) fax or mail it to the fax number or mailing address found on this and on all pages. (See, Contact page.) |
I would like to Apply for Admission for the
ST. PETERSBURG BALLET ACADEMY School Year 2012-2013 in St. Petersburg, Russia |
| Last Name: Student |
| First Name: Student |
| Address: Line 1 |
| Address: Line 2 |
| City: |
| State/Province: | Zip/Postal Code: |
| Country: | Nationality: |
| Tel: (day) | Tel: (eve) |
| Fax: | Mobile: |
| Email: |
| Date of Birth: | day | month | year |
| Age: | . | Female □ | Male □ |
| * Present Academic Grade (3-12): | * Present University Level: |
| * Ballet: School/Company/Teacher |
| Beginner □ | Intermediate □ | Advanced □ | Professional □ |
| Parent/Guardian: |
| Parent/Guardian: |
Method of Payment: |
A. BANK CHECK [USA only].
Enclosed, please find my
Application Fee of $250 USD
payable to: St. Petersburg Ballet Society. | ____________________________ USD |
B. WIRE TRANSFER, Worldwide [USA, too]
I am sending my
Application Fee of $250 USD
payable to: St. Petersburg Ballet Society • | ____________________________ USD |
PNC Bank • ABA #: 031100089 •
Account #: Please, Request Account #
PNC Bank, Midway Branch, 4725 Kirkwood Highway, Wilmington, DE 19808 USA |
| The Application Fee of $250 USD is non-refundable. (It covers the various administrative costs of the admission.) Once the student registers for the School Year, it is credited toward the Tuition. |
I submit my Application Form with my Application Fee.
I am applying for admission in one of the following ways:
A. Photos □ B. Video/DVD □ C. Personal Audition □ |
| Signature: [Parent or Guardian - Under Age 18] | Date: |
| . | . |
| Thank you for your application. We will be contacting you, as we receive it. |