Talent Show Application - International Talent Academy

STUDENT INFORMATION
Name*

First

Last
Date of Birth
Present School
Grade
CURRENT CONTACT INFORMATION
Present Address

Street Address

City

State / Province / Region

ZIP / Postal Code
Classes/Lessons child attends (include name of school/organization, program name, years attended)
PARENTAL INFORMATION
Mother
Father
Mother’s Name
Father’s Name
Mother’s Place of Work & Title
Father’s Place of Work & Title
Mother’s Email
Father’s Email
Best Cell to Contact
Home Phone
TALENT INFORMATION
Name of Act (Include all details). Also, please list additional participants in your act – limit to 5 people.
Please select type of act (all acts are limited to 3 minutes of time):
- Song
- Monologue/Poem recitation
- Dance
- Parent & Child Act
- Other
(Please specify)
*The instrument playing entries are not accepted for this Talent Show due to the limited number of acts.
*Please provide everything necessary to perform your act. Props, CD with the music (no vocals on the CD)
*Costumes/formal attire required at the talent show and in your video submissions
SUBMISSION DETAILS

Application Due: June 20th, 2016

VIDEO SUBMISSIONS DUE JULY 27, 2016 – DON’T WAIT, SUBMIT EARLY!
ITA reserves the right to use pictures/video of the Talent Show contestants on website, newspapers, Social Media.
- Please do no use pictures of my child
Please, check the box above if we may NOT use pictures/video of your child.

STUDENT INFORMATION