Application Form - Ensembleship

Brooklyn Acting Lab

Ensembleship Application
Birthdate: *

Month Day Year
School: *
Grade: *
Age at start of class: *
Which class(es) are you interested in for your child?
What is your child's interest in the performing arts? *

0/300
Why do you think Brooklyn Acting Lab is a good fit for your child? *

0/300
Additional Information

Answers to the following queries regarding gender, ethnic origin, and race are optional. We ask because some funding is contingent on us reporting this information. Additionally, it helps us to evaluate the ensembleships we provide.
Child's Gender Identity:

Male Female Trans; Non-binary, non-confirming Decline to state
Child's Pronouns:

She/her/herself He/him/himself They/them/themselves
Child's Race or Ethnicity (Check all that apply):

White Black or African-American, Caribbean East Asian South Asian American Indian, Alaskan Native, Hawaiian or Other Pacific Islander Latin(x)
II. Family Information:

Please provide background information.
Parent/Guardian 1
Name: *

First Name Last Name
Phone Number: *

Area Code Phone Number
Email: *
example@example.com
Address: *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Relationship to child:
Parent/Guardian 2
Name:

First Name Last Name
Phone Number:

Area Code Phone Number
Email:
example@example.com
Address:

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Relationship to child:
III. Financial Information:

This information is for office-use only and is kept strictly confidential. Please list only parents or guardians who provide financial support to the student(s).
Place of Employment: *
Position: *
Work Number: *

Area Code Phone Number
Salary/wage: *
Payment Schedule: *

Yearly Monthly Weekly Hourly
Other sources of income (e.g. Medicaid, child support, food stamps, other forms of financial aid): *
This absolutely will not be shared; this is only for determining ensembelship allocation.
Including the student(s), how many children or dependents are supported by these adults? (e.g., other children, full-time students, dependent parents, etc.):*
Other child expenses (such as various activities):
Please email a copy of your tax-return to admin@brooklynactinglab.org; feel free to redact your social security number.
Please tell us if there is anything else you would like us to know:
VIII. Applicant's E-Signature
By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.
E-Signature: *
Brooklyn Acting Lab is committed to equal opportunity in employment and education. BAL does not discriminate in any program or activity on the basis of race, color, religion, gender, age, national origin, disability, marital status, or any other protected class.
Child Full Name: *

First Name Last Name
Should be Empty:

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Brooklyn Acting Lab

Additional Information

II. Family Information:

III. Financial Information:

VIII. Applicant's E-Signature