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* 1. Please enter your contact information 

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* 2. What is the name of the school you attend? 

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* 3. School Zip Code

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* 4. Grade

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* 5. Why do you want to take this course? *

 

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* 6. Please mark all of the types of dance you have either tried or know about: *

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* 7. If you selected Other, please explain.

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* 8. As a part of the course, we will have 15 minute group discussion lessons in most sessions. Are you willing to actively participate? *

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* 9. Which Dates are you able to attend?

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* 10. Is there anything else you would like to tell us about yourself?

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