Full Name:   

Home Phone Number:   

Mobile Phone Number:

Address:

Email Address:

What is your goal with regard to acting?         select Act as a hobby and gain experience being in front of people Perform in my local community theatre Perform in local theatres and do some independent films Get an agent, perform regionally, and do commercials and industrial films I WANT MY OSCAR, EMMY, AND TONY AWARDS, BABY!!

What is your age range?         select under 12 13-18 19-25 late 20s 30s 40s 50s over 60

How did you find out about our classes?       select Postcard Newark Nite Craig's List Internet Search Shark Bites Newsletter Referred by a friend Other

If "referred" or "other", please elaborate:

Which class would you like to attend:       select Tuesday Afternoon 2p-4p Tuesday Evening 6p-8p Wednesday Evening 7p-9p Thursday Afternoon 2p-4p Thursday Evening 7p-9p Other

If your schedule doesn't allow you to attend any of the classes currently on the schedule, please suggest another time. If there is enough interest in that other time, we may start a new class.

Please indicate how you would rate your level acting experience         select New - No Experience Beginner - Some Experience Intermediate Advanced Professional

If you selected anything other than "New", please fill out this section.

Please indicate what kind of experience you have had (check all that apply):