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Page Parkes Center of Modeling & Acting Online Application

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Please note: The Page Parkes Center of Modeling & Acting offers services for students ages 4 and up.

Full Name: *

Address: *

City: *

State: *

Zip: *

Birthday: *

Gender:

Email Address: *

Home Phone: *

Work Phone:

Occupation or Student:

Parent's Name: if under the age of 13 must have parental consent

Height (e.g. 5'10"):

Weight:

Dress Size (Females):

Suit Size (Males):

Shoe Size:

Hair Color:

Eye Color:

Are you wearing braces?:

If yes, when will they be coming off?

Is your complexion clear?:

Do you have a singing talent?:

Have you had any previous training in acting or modeling?:

Did you complete your training?:

If so, when and where?:

How did you hear about us?:

Have you had any previous experience in any of the following areas?:






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