Ballet Nights Young Ambassador Indonesia
Application Form
PERSONAL DETAILS
Student Name
*
First Name
Last Name
Date of Birth
*
-
Day
-
Month
Year
Date
Gender
*
Please Select
Male-identifying
Female-identifying
Prefer not to disclose
Are you an Indonesian Citizen?
*
Please Select
Yes, I hold citizenship & I am training
Yes, I hold citizenship & I am working
No, but training or living full time in Indonesia
Vocational/Dance School Student Currently Attends
*
If permission is required, please seek this from the Director/Principal of your school
Awards and Achievements
Please add as appropriate
PARENT/CARER DETAILS
Parent/Carer Full Name (If under 18)
First Name
Last Name
Parent/Carer Email (if under 18)
example@example.com
Parent/Carer Phone Number
Please enter a valid phone number.
PAYMENT
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Registration Fee
*
prev
next
( X )
Ballet Nights Young Ambassador Indonesia
Audition will take place on the December 14th at the Taman Ismail Marzuki studios.
200,000.00
IDR
Quantity
1
2
3
4
5
6
7
8
9
10
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Would you like to be added to the Ballet Nights Mailing list for exclusive access to show updates, behind-the-scenes insights, performer spotlights, and priority offers for Ballet Nights events in South East Asia?
*
Please Select
Yes
No
Submit
Should be Empty: