First name(s):

Family name/surname:

Date of birth (dd/mm/yyyy):

UCAS number

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BA (Hons) Acting

Audition Form 2013 EntryIf you complete this form in hand writing, please use black ink throughout and block capitals on page 1. If you type into this form, please print it off when complete, sign and date it. Pleaseremember to bring this form and your photo (and any supporting information) to your audition event.

You can type into this document

When auditioning people for the BA (Hons) Acting degree, we also consider candidates for our Foundation Certificate in Acting and Musical Theatre.

This is an intensive full-time, one year course run by LIPA, which intends to help you develop as a confident, rounded performer. It is designed togive you a competitive edge to potentially help you gain a degree place at a leading performing arts institution. The tuition fee for 2013 entry is8,950. This is a private course so you will not be entitled to funding from the UK government for the tuition fee or your maintenance (cost ofliving). In 2013, we have up to two free places available on the Foundation Certificate in Acting and Musical Theatre for people from the lowestincome households. There are strict eligibility criteria attached to this. More information is available at:www.lipa.ac.uk/content/Courses/UndergraduateCourses2/StudentFinance.aspx

If you would like to be considered for theFoundation Certificate in Acting and Musical Theatre, please tick this box.

Personal details

Foundation Certificate in Acting and Musical Theatre

(Underline the name you use)

PLEASE

AFFIX

PASSPORT

PHOTO HERE

Please continue to page 2

FOR OFFICE USE ONLY

Admissions Ocer: Assessors Name:

Audition date:

Outcome: UNCOND COND RECALL UNSUCCESSFUL

Recall date:

Outcome: UNCOND COND RESERVE UNSUCCESSFUL

Signed:

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Please list the most important activities that you have undertaken that relate to the Acting degree, starting with the most recent. (Please continueon a separate sheet if necessary and attach your acting CV if you have one.)

Experience directly related to the Acting degree

Date or dates Activity Your role

*Professional

*Amateur

Date or dates Activity Your role

*Professional

*Amateur

Date or dates Activity Your role

*Professional

*Amateur

Date or dates Activity Your role

*Professional

*Amateur

Date or dates Activity Your role

*Professional

*Amateur

Date or dates Activity Your role

*Professional

*Amateur

Please list any activities that you have undertaken that demonstrate a wider interest or involvement in the arts and entertainment sector. (Please continue on a separate sheet if necessary.)

Interdisciplinary experience / interest

Date or dates Activity Your role

*Professional

*Amateur

Date or dates Activity Your role

*Professional

*Amateur

Date or dates Activity Your role

*Professional

*Amateur

Date or dates Activity Your role

*Professional

*Amateur

*Any activities you have undertaken in school or college or on a voluntary basis outside the school/college environment should be indentified as amateur.Professional relates to any paid work you have undertaken.

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Relevant training

Relevant training

Please list any training you have undertaken including any qualifications (formal or informal), starting with the most recent. We do not mean schoolor college qualifications (such as GCSEs, A-Levels and IB). Examples of training can include dance training, music training, short courses, summerschools, etc

Career aspirations

Please state your career aims and aspirations and how you anticipate that your time at LIPA will help you achieve these.

Other skills

Describe any other skills you have that may not seem relevant to the performing arts.

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How did you hear about LIPA?

Please tick which (if any) of the following have helped to influence your decision to apply to LIPA.

LIPA prospectus LIPA website Coverage in the media Teacher/Tutor

Careers Adviser Attendance at a LIPA open day Advertisement Attendance at HE fair

The British Council Information about LIPA in a directory Recommendation

Other:

Declaration

I understand that if I have knowingly supplied false information on this application that I am liable for immediate exclusion.

I confirm that to the best of my knowledge, the information on this form is correct and complete.

I confirm that I have completed this form by myself. If you have not, please state why:

LIPA is registered under the Data Protection Act 1998 and information given on this form will only be used in accordance with the terms of LIPAsregistration. I give my explicit consent to the processing of my data by LIPA.

I have read, understand and abide by the terms and conditions.

Signed Date

REMEMBERBRING THIS FORM WITH YOU TO YOUR AUDITION

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LIPA will use all reasonable endeavours to deliver courses in accordancewith the descriptions set out in the prospectus.

The course charts are indicative and may be subject to change. LIPA islargely dependent on public funds that need to be managed in a waythat is efficient and cost effective. We therefore reserve the right tomake variations to the content of courses and/or method of delivery; todiscontinue, merge or combine courses if we consider that such actionis necessary in the context of LIPAs wider purpose. LIPA also makeschanges to its programmes to reflect the changing needs of the artsand entertainment industries.

In the rare event of us discontinuing a course we will use all reasonableendeavours to provide a suitable alternative, failing which, we shall givefour weeks notice prior to the start date for the course and any feespaid will be refunded in full. LIPA reserves the right to withdraw asubject or course up to four weeks after the published start date,where it is not considered viable and an alternative subject will beoffered or a pro-rata refund of the course fee will be given.

Abiding by LIPAs rules and regulations

A condition of enrolment is that you abide by, and submit to, LIPAs rulesand regulations as contained in our student handbook. These rules andregulations are subject to amendment from time to time. Extracts fromthe current Student Handbook can be obtained on request from theLIPA Admissions Department.

Payment of fees

Tuition fees are, in general, due for payment in full by the student on orbefore enrolment. First year international degree course students andall Foundation Certificate course students are required to pay a depositamounting to 25% of the first years fee on or before 31 May.

UK and EU students who do not take up their Student Loanentitlements are required to pay their fees in full on or beforeenrolment.

Students in receipt of UK or overseas Government loans, US FederalFinancial Aid, Professional and Career Development Loans, private loansor sponsorship from a recognised source, may pay their fees inaccordance with the terms of the receipt of their fundingarrangements. Written confirmation of this funding must be providedon or before enrolment.

Other students who cannot or do not access the public funding sources available to them may pay their fees in two equal instalmentsonly if they provide a letter of guarantee from a party acceptable to the Institute.

Fees are payable online by debit or credit card.

WithdrawalsLIPA reserves the right to retain up to 50% of any deposit paid where awithdrawal of acceptance of an offer is received after 31 July in the yearof entry. Students who are receiving US Federal Financial Aid will berefunded as per US Department of Education R2T4 regulations.

All students are allowed a four week cooling off period from the date ofenrolment in which to decide if they wish to continue with their studiesor withdraw from their course. In the event of a student withdrawingwithin the first four weeks they will be charged only an administrationfee which is currently 100.

Full-time undergraduate and Foundation Certificate studentswithdrawing after the cooling off period will be charged anadministration fee, currently 100 plus a proportion of the fee payableby the student calculated on a pro-rata basis on the number of weeksof study undertaken, commencing from the date of enrolment.

Students from outside the European Economic Area who require astudent visa, should note that the Institute is obliged to notify the UKBorder Agency if a student has multiple unauthorised absences, fails toenrol on their course or terminates their studies.

Please retain these terms and conditions for your records.

Terms and conditions

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Other Skills: Career Aspirations: Relevant Training: Other: Check Box27: Check Box28: Check Box29: Check Box30: Check Box31: Check Box33: Check Box34: Check Box35: Check Box36: Check Box37: Check Box38: