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NCTC Summer Camps Enrollment Form
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Thank you for your interest in New Conservatory Theatre Center`s programming.
DAY CAMP STUDENTS for ages 9-12:
*NEW NCTC STUDENTS Complete this form and return it with a $25 non-refundable registration/interview fee (one-time only). You will be contacted to set up an interview time.
*RETURNING STUDENTS: Complete this form (ONLY if your information has changed) with a 250.00 credit card deposit and we will see you on the first day of camp. No interview is needed.
TEEN SUMMER ENSEMBLE & SUMMER JAM PARTICIPANTS for ages 12-16:
Complete this form with a 250.00 credit card deposit (or check) and we will see you at the Saturday, May 11, placement ORIENTATION from 10am to 12pm. The orientation is free, your credit card details are needed only to hold your teens` place in the program.
YOU HAVE TWO OPTIONS WHEN FILLING OUT THIS FORM:
1.Fill out the application, including Credit Card details, and ELECTRONICALLY submit form.
*MasterCard, VISA, American Express and Discover Card are welcome.(5% Service Charge)
2. Fill out the application, PRINT and MAIL, with a check (the 25.00 interview fee or 250.00 deposit check or cc details) to:
New Conservatory Theatre Center
25 Van Ness Ave. Lower Lobby
San Francisco, CA 94102
Attn: Sylvia Hathaway, Summer Programs
Scholarship applications are available after interview or audition. 10% discount for families or participating in multiple camps.
Payments: All placed participants should send a $250.00 deposit before the first day of the program. All final payments must be submitted before or on the first day of the program. Due to the short sessions, there are no payment plans during the summer.
For questions about student placement, space availability or for an interview time, please contact: Andrew Nance, NCTC Conservatory Director at (415) 694-6148 or by email to Sylvia@nctcsf.org
Sylvia@nctcsf.org
Student Information
*Have you taken a class at NCTC before?
Yes
No
*Student First Name:
*Student Last Name:
Gender:
Female
Male
Ethnic Origin
Select
Ethnic Origin
Caucasian
Chinese
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Filipino
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hispanic
European
Russian
Pacific Islander
African American
Native American
Indian
Middle Eastern
Mexican American
Spanish
Eurasian
Pacific Islander
Jewish
other
Birth Date:
Grade in Fall:
Name of school you are currently attending:
Home Phone:
Student email address:
Student Cell Number:
Mailing Address
Mailing Address
Apartment No#:
City:
State:
Choose a State
Alabama
Alaska
Arizona
Arkansas
California
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Connecticut
Delaware
District of Columbia
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Hawaii
Idaho
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Kentucky
Louisiana
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Maryland
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Rhode Island
South Carolina
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Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
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Zip Code:
Emergency Contact Information - Other than Parent
First Name:
Last Name:
Relationship to Student:
Emergency Contact Phone Number:
Student Medical History
Pertinent Medical Info (Learning Concerns, Allergies, etc.)
Parent/Guardian Information
Parent/Guardian #1 Full Name:
Cell/Work Phone for above:
Parent #1 email address:
Parent/Guardian #1 Occupation:
Parent/Guardian #1 Employer:
Parent/Guardian #2 Full Name:
Cell/Work Phone for above:
Parent #2 email address:
Parent/Guardian #2 Occupation:
Parent/Guardian #2 Employer:
NCTC Camp Selection
*Camp Selection:
Choose the camp you would like to attend
Youth Day Camp I(ages 9-12) Mon.,June 17 - Wednesday, July 3 $650.00
Youth Day Camp II (ages 9-12)from Mon., July 8 - Fri.,July 26 $675.00
Teen Summer Ensemble*(ages 12-14) Mon.,June 24 - Sat.,July 21 $675.00
Teen Summer Jam (ages 13-16) Mon., July 22 - Sat., July 27 $250.00
Both Teen Summer Ensemble & Summer Jam Mon. June 24 -Sat., Jul $825.00
YouthAware Out&United**(LGBTQIA teens 14-19)July 8 - Sun.,Aug 4 $00.00
*Mandatory Teen Ensemble orientation on Sat., May 11 from 10-12 $00.00
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Total
Sub-Total:
New Student Registration Fee
Choose
New Student Registration Fee
New Students: 25.00 Non-Refundable Registration/Interview Fee $25.00
Continuing NCTC students DO NOT have to pay this fee. $0.00
Credit Card Service Fee
Choose Credit Card Service Fee
Credit card payments %5.00
Class Tuition Total
Checkout
Check made payable to NCTC
Mail to address below.
Credit Card Brand:
Choose a Card
Visa
Master Card
American Express
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Credit Card Number:
No dashes or spaces please
Expiration Month:
Month
January
February
March
April
May
June
July
August
September
October
November
December
From your card
Expiration Year:
Year
2009
2010
2011
2012
2013
2014
2015
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2017
2018
2019
2020
From your card
Comments and/or Questions
Submit questions or comments:
Parent/Guardian Permission Authorization
Important Note***By clicking the SUBMIT button below you are indicating that you are the parent/guardian of the student applying for the class(es). You authorize and approve that all information is true and accurate, giving full permission for the student to attend all classes at the NCTC facility and that this will act as an electronic signature. If payment is by credit card, you authorize NCTC to apply all class tuition charges to the credit card for payment unless otherwise indicated. Note: Photographs and/or videos of NCTC students may appear on NCTC`s website, posters, fliers and brochures.
Thank you for your interest in NCTC`s Programming!
NEW CONSERVATORY THEATRE CENTER
25 Van Ness Avenue at Market Street | San Francisco, CA 94102
NCTCSF.ORG
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