Refer someone for a free place

Referrer name *

Organisation & position *

Select the criteria that apply for this referral *
Annual family income of £28,000 or lessParent or guardian is current full-time studentDLA (either parent/guardian or child)Asylum Seeker (SS or NASS)Universal Credit (JSA/ESA)Pensioners, Housing Benefit, or Working Tax CreditPupil Premium / free school mealsPensioners, Housing Benefit, or Working Tax CreditOther circumstances

Reason for referral *

Referrer email *

Referrer contact number *

Student name

Student gender
MaleFemalePrefer not to say

Student date of birth

Parent / guardian name

Parent / guardian contact number

Parent / guardian email address

Address with postcode

Please tell us how you found out about our free places? *

I have read, understood and agree to Montage Theatre Art’s Privacy Notices. *
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