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Starfish Application Form

Please note there is normally a waiting list of up to 6 months and preference is given to applicants within the Lewes District Council area.

First name: *
Last name: *
Street address:

Town:
Postcode:
Date of birth:
Age: *
Tel. No.
Email address: *
Check sessions you can attend:		Tuesday Wednesday Thursday
Programme:
Are you are signing as		a member of a band an individual
Name of your band:
Number of members in the band:
Do you sing or play any instruments?
What kind of music interests you?
Have you taken part in any Starfish activities?		Yes No
		Please enter the letters in the image *