2009-2010 Academy Independent Winter Guard Application Form
Payment via credit card of the $40 application fee is required with this application.

Contact Information

First Name
Last Name
Mailing Address
City
State
Zip Code
Primary Phone Number
Alternate Phone Number
Date of Birth MM/DD/YYYY
Gender
T-Shirt Size
Email Address

Were you referred to these auditions by someone?
If yes, who referred you?

Parent Information

(This information is used for emergencies and booster contacts)

Name (s)
Address
City
State
Zip Code
Primary Phone Number
Email Address

Payment Information

Full Name
Billing Address
City
State
Zip Code
Card Type
Name on Card
Card Number
Expiration Date  MM/YYYY
CVV Code

Confirmation

By clicking the submit button below you authorize Arizona Academy of the Performing Arts to charge your credit card for the $40.00 application fee.

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