Advance Post Production and Studio Photography WORKSHOP

Application Form
(to be completed and sent electronically to theimagepark@gmail.com by 25th January 2012) Name: [ ] Email Address: [ ] Location: [ ] Age: [ ] years old Citizenship: [ ] Academic Qualification: 1. [Qualification 1] 2. [Qualification 2] 3. [Qualification 3] (add as necessary) Workshops and Training Achieved: 1. [Merit 1] 2. [Merit 2] 3. [Merit 3] (add as necessary) Other Significant Achievements: 1. [Achievement 1] 2. [Achievement 2] 3. [Achievement 3] (add as necessary) Tell us, in not more that 400 words, why would you want to enroll yourself in this workshop: [Write here. Use paragraph breaks if necessary.] Gender: [ ] Occupation: [ ]

Signed [Participant's Name] Date: [ ]

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