Name Sex Height Weight

Address City State Zip

Email Phone Are you at least 18? Yes No

Are you a member of AGMA? Yes No    If Yes, enter membership number

How did you hear about the audition? Ballet San Jose Website Internet Search Flyer Friend

Magazine (please name): Other (please specify):

Do you have a history of illness or injury which might in any way be adversely affected by the rigorous physical demands of being a professional ballet dancer with Ballet San Jose? Yes No

   If yes, please explain

Are you a U.S. citizen? Yes No    If NO, answer the questions in the box at the bottom of the form

Which position are you seeking? A salaried company position A salaried apprentice position

Briefly provide the following information (resumes and photos will be collected before the audition):

Performance Experience - Company	Repertory Role	Date/Year

"By entering my initials, I recognize that Ballet San Jose is NOT liable
for any injuries that I might incur during this audition process"

Initials Date