Assisted Application Scheme Registration Form

Applicant Details
First Name*
Surname*
Gender*
Pronouns (e.g. he/him, she/her, they/them)

A pronoun is a word that refers to either the people talking (“I” or “you”) or someone or something that is being talked about (like “she”, “it”, “them”, and “this”). Gender pronouns (he/she/they/ze etc.) specifically refer to the person you are referring to.
Please let us know how you identify*
Date of Birth*
DD slash MM slash YYYY
Age on 1 September 2024*
Email Address*

Please note that all emails between the school and the applicant will be sent to this address prior to the course commencing. We recommend using the applicant’s email address where possible.
Secondary Email Address

If you would also like a parent/guardian to receive these emails, please provide their email address in the ‘Secondary Email Address’ box.
Mobile Phone Number*
Home Phone Number
Home Address*
Postcode*

Parent / Guardian Details
Parent / Guardian
Central requires details from at least one parent/guardian per applicant. You may also provide details of an additional parent/guardian below.
First Name*
Surname*
Relationship to Applicant*

E.g. mother, carer etc.
Email*
Mobile Phone Number*
Home Phone Number
Parent / Guardian
First Name
Surname
Relationship to Applicant

E.g. mother, carer etc.
Email
Mobile Phone Number
Home Phone Number

Household Income
Please provide details of your household income information, showing income from all sources BEFORE the deduction of tax. Figures are required for the whole financial year April 2021-2022. This information can be found on your Annual Tax Summary which is sent each year by His Majesty’s Revenue and Customs (HMRC). Applicants over the age of 25 will need to provide details of your OWN income. Applicants under the age of 25 There are a number of reasons why applicants under the age of 25 are unable to provide the household income of a parent or guardian. It may be that you are estranged from your parent or guardian i.e. that you do not have contact with them, or that you are, or have recently been, looked after by the state. It may be that your parents are no longer alive. If any of these apply to you, please provide details of your OWN income and proceed to the next question. Please be aware that we may request evidence of income/benefits.
Income Earner
Earned annual household income (£)*
If you receive means tested benefits, please give annual amount here (£)
Please provide details of any other income here (e.g property, unearned income, inheritance or other) (£)
If you are UNDER the age of 25 and are providing details of your OWN income please tick the reason(s) below
- I am estranged from my parent or guardian
- I am, or have recently been, looked after by the state
- My parents are no longer alive

Marketing
Mailing list
- I would like to receive further details about Widening Participation opportunities at Central School of Ballet.
- I would like to hear more about Central School of Ballet and Ballet Central, including news, fundraising, forthcoming events and wider opportunities.
If you would like to be contacted about future Widening Participation opportunities and events at Central School of Ballet, please tick one or both boxes to specify what you wish to receive. Please note that you must be aged 18 or over to receive emails from Central School of Ballet. (If you do not wish to receive emails regarding other opportunities, please leave these boxes blank. Please note that you will therefore only receive emails about courses for which you attend.)
Please provide the email address where you would like to receive these updates
Long-term Evaluation
Central School of Ballet may wish to contact you to assess the long-term impact of our work. Do you consent to being contacted?*
- Yes
- No
Data Processing Statement 23-24
Central School of Ballet is a ‘Data Controller’ of your data, and holds and processes ‘personal data’ (which may include ‘Special Categories of personal data’) as defined in the General Data Protection Regulation (GDPR) about applicants and students which is provided to them by you (or which is otherwise received from third parties) for their own, separate purpose(s).

Central School of Ballet needs to process (that is, collect, use, store and ultimately securely dispose of) personal information about you as a student to be able to record your application to the School. (Please tick below).
*
- I confirm I give my explicit consent for the information and media I have provided in this form, including any information on injuries and medical conditions, to be processed by appropriate individuals only in accordance with access protocols. I can withdraw my consent at any time by emailing info@csbschool.co.uk.
Declaration
*
- I confirm that to the best of my knowledge all information provided in this form is true and complete
Applicant Signature*
Parent / Guardian Signature*

Step 1 of 5

Applicant Details

Parent / Guardian Details

Parent / Guardian

Parent / Guardian

Household Income

Income Earner

Equality and Diversity Information

Marketing

Long-term Evaluation

Data Processing Statement 23-24

Declaration