Pre-Enrollment Questionnaire

IMPORTANT! Please verify that all information is correct before clicking the "Submit" button. If you have any questions, please contact Theatrical Corner at 908-326-6919 or info@theatricalcorner.com. Thank you!

* Indicates Required Fields

Your Name*
(First Name, Last Name)

 

Email address*

 

Confirm email address*

 

Day Phone*

  ( ) - -

Evening Phone*

  ( ) - -

Mother's Name*
(First Name, Last Name)

 

Father's Name*
(First Name, Last Name)

 

Student's Name*
(First Name, Last Name)

 

Street Address*

 

City, State, 5-Digit Zip-code*

 

Student's Date of Birth*
(MM/DD/YYYY)

 

Student’s Age

 

Name(s) of Additional Children you want to enroll (please separate names with commas)

 

When are you interested in starting classes?*
(MM/DD/YYYY - Note: This year classes begin on 09/04/2013)

 

Program(s) of Interest*
(Select all that apply)

 

 

 

 

Questions/Comments