Fei Tian Academy of the Arts California Application Form

Feitian Academy of the Arts - California
2010-2011 School Year Student Application

* Student First Name:
Middle Name:
* Last Name:
* Age:
* Birth Date (MM/DD/YYYY):
* Gender:		M F
Height:		ft in

Weight:		lbs
Address: Street
City
State/Province
Zipcode
Country
* Phone:
Email:

Parent/Guardian:(required for students below 18 years of age)

* First Name:
* Last Name:
Relationship to student:
Address: Same as student:

Street
City
State/Province
Zipcode
Country
* Phone:		(Home) (Work) (Mobile)
* Email:

Emergency Contact Persons:

* First Name: * Last Name: * Relationship: * Phone:

First Name: Last Name: Relationship: Phone:

Please answer the questions in the survey as accurately as possible to ensure the best placement/arrangements are made for your student:

1. Academic school currently enrolled in or last completed:
Name: Public or Private Grade:

2. Has your student ever received training in dance? Yes   No
If you answered Yes, please check all that apply. My student has received training in:
Classical Chinese Dance       Ballet        Folk/Ethnic Dance
                              Other:
Please provide the following information about your student's dance training:
Name(s) of Dance School:
                          Location:
             Years of Training:
             # of Hours/week:

3. How much do you know about Classical Chinese Dance?
A lot A little Nothing

4. What is your reason for pursuing Classical Chinese Dance?
I would like to become a professional dancer of Classical Chinese Dance.
I would like to improve my physique and posture
I enjoy experiencing different forms of dance
I would like to learn more about Chinese culture.

5. Please select your preferred programs.
(For details on these programs please visit our Class Schedule section.)

Summer program

6. Please select the language that you speak (check all that apply and check whether fair or fluent).
English ( No   Fair   or Fluent )
Mandarin ( No   Fair   or Fluent )
Cantonese ( No   Fair   or Fluent )
Spanish ( No   Fair   or Fluent )
other ( No   Fair   or Fluent )

7. Does your student have any medical/health concerns? Yes No
If you answered Yes, please specify below:

* Enter this Security Code
(If you type a wrong security code, refresh browser to get a new security code)

The Institute for Arts and College (DBA Feitian Academy of the Arts - California) admits students of any race, color, national origin, and ethnic origin to all the rights, privileges, programs, and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, national origin, and ethnic origin in administration of its educational policies, admission policies, scholarship and loan programs, and athletic and other school-administered programs.

For more information, contact us at:
Feitian Academy of the Arts California
101 15th Street, San Francisco, CA 94103
Phone: 415-431-3161
Email: sfdenise.miller@feitianacademy.org