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ENROLMENT FORM
Please Complete Form in BLOCK CAPITAL Letters
Registration Fee $50.00
Name:    Male  Female
Home Address:    Telephone No. : 
Date of Birth:     Age on Last Birthday: 
Postal/Mailing Address (essential): 
   E-mail: 
Name of School Attending: 
 
Names of Parents/Guardians:   (name)
(Address)     (home #) 
(work #)    (relationship to applicant) 
(Name) 
(Address)     (home #) 
(work #)    (relationship to applicant) 
Contact Person in Case of Emergency:    (name)
(Address)     (home #) 
(work #)    (relationship to applicant) 
Sponsor of Fees for the Applicant:    (name)
(Address)     (home #) 
(work #)    (relationship to applicant) 
 
How did you hear about us?  Word of Mouth  Radio Ad  TV Ad  Internet   Promo Literature
Other 
Has the Applicant had any previous Classical Ballet and/or Modern Dance Training?
Yes   No If “Yes”, please answer the following questions
Name & Address of Dancing School Attended:  
Number of Years of Training:    Grades Completed: 
 
Allergies/Medical Conditions: 
Additional Information: 
Signed:     Name (PRINT): 
Relationship to Applicant: 
 
FOR OFFICE USE ONLY
REG. FEE: $                                                                    GRADE: 
TUT. FEE: $    
UNIFORM: $    
ADDITIONAL :    
INFORMATION