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The Walnuts Application Form
Please complete this form to sign up for DNTC's adult acting company; The Walnuts.
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* Indicates required question
Full Name
*
Your answer
Address Line 1
*
Your answer
Address Line 2
Your answer
Address Line 3
Your answer
Town
*
Your answer
County
*
Your answer
Postcode
*
Your answer
Telephone Number
*
Your answer
Email Address
*
Your answer
Preferred Method of Contact
*
Email
Text
Phone Call
Closed Facebook Group
Date of Birth
*
MM
/
DD
/
YYYY
Previous Experience
*
Your answer
How did you hear about The Walnuts?
*
Your answer
Are there any Monday evening rehearsals you cannot attend?
*
Yes
No
If yes, please provide dates and details
Your answer
Do you suffer from any illness, allergy (including food allergies) or condition requiring medication?
*
Yes
No
If yes, please provide details
Your answer
Do you take regular medication?
*
Yes
No
If yes, please provide details
Your answer
Do you wear contact lenses?
*
Yes
No
I give consent for photos/videos to be taken.
*
Photos/videos may be used for promotional purposes and so, if used, will be going out in to the public domain
Yes
No
GP Name and Address
*
Your answer
GP Phone Number
*
Your answer
Additional Emergency Contact Name
*
Your answer
Additional Emergency Contact Mobile Number
*
Your answer
Additional Emergency Contact Home Telephone Number
Your answer
Can we add you to our Mailing List?
*
Yes
No
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