Online Application - PNX Global

Personal Information

Full Names

Last Name

Preferred Name

Gender Male Female

Race

Date of Birth

Age

ID Nr./Social Security Nr

First Language

Other Languages

Drivers License

License Code

Contact Information

Postal Address

Postal Code

Street Address

Postal Code

Mobile Number

Home Number

Applicant's Email Address

Parent/Guardian/Sponsor Information

Please Pick Guardian Father Stepfather Guardian

Name

Surname/Last Name

Occupation

ID Nr./Social Security Nr

Tel (H)

Tel (W)

Fax Nr

Mobile Nr

Email Address

Postal Address

Postal Code

Street Address

Postal Code

Parent/Guardian/Sponsor Information

Please Pick Guardian Mother Stepmother Guardian

Name

Surname/Last Name

Occupation

ID Nr./Social Security Nr

Tel (H)

Tel (W)

Fax Nr

Mobile Nr

Email Address

Postal Address

Postal Code

Street Address

Postal Code

Person Responsible For Your School Fees

Name and Surname

Contact Number

Email Address

Course Detail

Your Choice of Course/Programme

Please specify your major Dance Drama Music Dance, Drama Drama, Music Dance, Music

Where did you hear about us?

Friend

Expo

Tour

Family

Instagram

Magazine

Website

Facebook

PNX Sudent

Video

Church

School

Flyer

Twitter

Other

If Other, Where?

Applicant's Academic Training Information

Highest Grade Past

Name of School

Year

Type of School

Subjects

Subject 1 and latest mark

Subject 2 and latest mark

Subject 3 and latest mark

Subject 4 and latest mark

Subject 5 and latest mark

Subject 6 and latest mark

Subject 7 and latest mark

Subject 8 and latest mark

Tertiary Qualifications

Qualification 1

Date

Institution Organization 1

Qualification 2

Date

Institution Organization 2

Qualification 3

Date

Institution Organization 3

Religious Background

Church Denomination

Name of Congregation

Name of Pastor/Ministor

Medical Information

Indicate your state of health: (1-Bad;5-Good)

Eyes 1 2 3 4 5

Hearing 1 2 3 4 5

Overall Health 1 2 3 4 5

PLEASE NOTE: A lot of our activities on campus become quite physical (a lot of fun), so please indicate if you might have any limitations.

If you have previsously or are currently suffering from a illness, disease, or disorders please write them down.

Nature

Degree

Date

Duration

Medication

Habits

Do you smoke? Yes No

If yes, are you willing to quit?

Do you use alcohol? Yes No

If yes, how often?

Are you presently using any form of drug related substance (even mediacal related)? Yes No

If yes, specify the tipe and duration?

Personal Experiences

Which Experiences are Applicable to Yourself

Rejection by Parents

Misuse of Alcohol

Serious Depression

Trespassing of the Law

Suicide Attempts

Homosexual/Lesbian Relationship

Occult Practices

Nutritional Problems/Issues

Misuse of Drugs

Physical Abuse

Emotional Abuse

Sexual Molestation

Sexual Relationship

Pornographic Exposure

Serious Love Relationship Failure

Masturbation

If other, specify:

Have you ever undergone or received counseling, psychological or medical help in the handling of these experiences? If yes, how long?

With Whom (Name and Surname)

Contact Number:

Are/Where You On Medication?

Are you stil using mediaction? If yes, specify medication and dosage:

Would ypu have a problem in portraying any of the above-mentioned problems in our productions? If yes, specify and why:

What Best Describes You 1

What Best Describes You 2

What Best Describes You 3

What Best Describes You 4

What Best Describes You 5

What Best Describes You 6

What Best Describes You 7

What Best Describes You 8

What Best Describes You 9

What Best Describes You 10

What Best Describes You 11

What Best Describes You 12

What Best Describes You 13

What Best Describes You 14

What Best Describes You 15

What Best Describes You 16

What Best Describes You 17

Pick one in Each Row

Pick 1

Declaration

Applicant Name and Surname

By clicking this button you declare that the information is correct.

Thanks for your application for next year.

Please Complete Application Form

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