Adaptive Dance Interest Form

Welcome!

Thank you for your interest in the Boston Ballet Adaptive Dance program! Please take a few minutes to provide us with some information so we can best respond to your request. We will be in touch with information regarding your area of interest. Thank you!

Question Title

* 1. Please enter your basic information:

Name

Address

City/Town

State

ZIP/Postal Code

Email Address

Phone Number

Question Title

* 2. How did you find out about the Adaptive Dance program?

MDSC Buddy Walk

Boston Ballet website

The Federation for Children with Special Needs

A conference or community event (please specify which below)

A friend (please specify below)

Other (please specify below)

Please specify if applicable

Question Title

* 3. What are you interested in doing?

Enrolling myself or a student in the Adaptive Dance Program

Working or volunteering with Adaptive Dance

Becoming trained as an Adaptive Dance instructor

Starting an Adaptive Dance program at a studio or community site

Scheduling an "Everyone Can Dance" 90-minute inclusive movement workshop

Other (please specify)