Date: Type Of Workshop:
Last Name: First Name: MI:
Professional Name:
Address: Apt # :
City: State: ZIP:
Home Phone: Work Phone:
Do not write in this box. Administrative use only:
Male/Female D.O.B.

Social Security No.

 Drivers License No. SAG AFTRA EQUITY AFM

Prior Related Education (Acting - Modeling - Dance - Voice - etc.)

Completing this section will aid your acting coach in placing you in a proper workshop level. It is not necessary to have studied in any other forum or school to be considered for enrollment. If none, please mark none.

School Name City, State

Instructor

 Course How Long
         
         
         

Related Experience (Film - Industrials - Commercials - Stage - etc) Submit resume if available.

Production Name Type

Role

 Production Company When
         
         
         
C.A.S. workshops are designed to allow you to grow at your own pace, with accent on individuality and personal attention, creating a strong, personal supportive environment with your coaches, artistic directors and fellow program participants.

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Applicant's Signature

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Gaurdian's Signature (If Under 18)
How Did You Hear Of Our Workshop?:

Chicago Actors Studios | 1567 N. Milwaukee Avenue Chicago, IL 60622 | Phone: 773.645.0222 | Fax: 773.767.4151