Byham House Application

Welcome to the Byham House Application!
The deadline for this application is April 20, 2020. We look forward to reading your responses!
Applicant Information
Applicant Full Name*
First Last
Preferred Name*
Gender*
Date of Birth*
MM slash DD slash YYYY
Grade for 2020/21 Academic Year*
Home Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone*
Applicant Email*
Applicant Cell Phone*
Country of Citizenship*
Place of Birth*
How did you hear about Byham House?*
Are you attending our 2020 Intensive Summer Program?*
Parent/Guardian Information
Must include at least one (1) parent or guardian.
Home Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Parent/Guardian 1 Full Name*
First Last
Parent/Guardian 1 Relationship to Applicant*
Please specify:
Parent/Guardian 1 Primary Phone*
Parent/Guardian 1 Email*
Parent/Guardian 1 Employer
Parent/Guardian 1 Occupation/Title
Parent/Guardian 1 Work/Alt. Number*
Parent Guardian 2 Full Name
If applicable.
First Last
Parent/Guardian 2 Relationship to Applicant
Please specify:
Parent/Guardian 2 Primary Phone
Parent/Guardian 2 Email
Parent/Guardian 2 Employer
Parent/Guardian 2 Occupation/Title
Parent/Guardian 2 Work/Alt. Number
Applicant lives with...*
Please specify:
Please list name(s) of guardians living with Applicant:
Please describe Applicant's household(s) and family structure?*
To whom should correspondence be sent?*
Who is responsible for financial obligations?*
Ballet Training & Background
Where do you currently train?*
Number of ballet hours per day*
Number of days of ballet per week*
Number of years en pointe*
Hours per week en pointe*
Total number of hours dancing per week (including rehearsals)*
Please list previous ballet schools attended (name, address, phone, dates of attendance, levels).*
What injuries have you experienced within the last year? What type of treatments did you utilize? What strategies have you learned to prevent further injuries?*
Academic Information
Please list all previous academic schools attended (name, address, phone, dates of attendance, grades completed).*
FOR GUARDIAN(S): How does the applicant plan to fulfill their academic requirements for the 2019-2020 academic year?*
Please specify:
FOR GUARDIAN(S): If different from past years, how will you support the applicant's success?*
FOR GUARDIAN(S): Our academic requirements for residing in the Byham House requires residents to be working towards a high school diploma and progressing in an efficient, timely manner. Do you foresee any reasons that the applicant would not be able to fulfill these requirements? If so, please state them here.*
FOR GUARDIAN(S): What support services do you feel the applicant would need to be successful both academically and at PBT School?*
Supplemental Information
Recent Headshot*
Max. file size: 256 MB.
Format: .jpg or .png
Guardian Questionnaire
Has the applicant ever lived away from home? Please explain.*
What would you consider the applicant's greatest strengths?*
In what areas do you feel the applicant could benefit from extra support?*
What concerns do you have for the applicant?*
What specific aspirations do you have for the applicant's experience in this program?*
Please feel free to provide any additional information that will allow us to better know the applicant.*
GUARDIAN ELECTRONIC SIGNATURE*

Please type full name.
Today's Date*
MM slash DD slash YYYY
Student Questionnaire
What specific aspirations do you have for your experience in this program?*
What type of lessons do you think being a part of the Byham House community will teach you?*
Please tell us about a time when you had a conflict with someone (sibling, friend or classmate) and how you resolved it.*
What have you done in the past year to enhance your current knowledge of cultures and viewpoints that are different from your own?*
What type of support services do you think you may need to feel comfortable, safe and happy at Byham House?*
Byham House residents have a requirement to fulfill volunteer hours. What type of organizations would you be interested in volunteering for?*
STUDENT ELECTRONIC SIGNATURE*

Please type full name.
Today's Date*
MM slash DD slash YYYY
Application Fee
Non-refundable application processing fee. No tuition deposit is required at this time.
Byham House Application Fee*
Price:
Total
$0.00
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Pittsburgh Ballet Theatre

Byham House Application

Welcome to the Byham House Application!

Applicant Information

Parent/Guardian Information

Ballet Training & Background

Academic Information

Supplemental Information

Guardian Questionnaire

Student Questionnaire

Application Fee