Premier Dance Academy
Registration
2017-18

 
PARTICIPANT INFORMATION
Last Name * (* indicates required field)
First Name *
Male/Female *
Current Grade *
Birthdate * (Month/dd/yyyy) (ie: May/19/2002)
PRIMARY PARENT CONTACT INFORMATION
Primary Parent Contact Name *
Primary Contact Telephone *
Primary Contact Email *
Primary Contact Home Phone
Primary Contact Work Phone
Primary Contact Cell Phone
Address *
City *
Postal Code *
OTHER PARENT CONTACT INFORMATION
Other Parent Contact Name
Other Parent Contact Telephone
Other Parent Contact Email
Other Parent Contact Home Phone
Other Parent Contact Work Phone
Other Parent Contact Cell Phone
Address (If different from above)
City
Postal Code
ADDITIONAL INFORMATION
Student's Current School *
School Location * (ie: West Vancouver, North Vancouver, etc.)
School Attending this September *
Program Selection * (Level 1 or Level 2?)
How Many Years of Studio Dance Experience *
Current Dance Studio (if applicable)
Style/s of Dance Trained In *
If  Level 2 provide Dance Studio Director’s Phone:
If Level 2 provide Dance Studio Director’s Email:
Please submit the following information via .pdf .doc or. rtf.
(use the "Browse" button to attach the file from your computer
)
  1. Dance goals: Tell us not only your dance goals, but also let us know what you hope to accomplish by participating in the Premier Dance Academy.
  2. Dance Exams Passed (Indicate style, association & grade).
  3. Dance or Performing Arts Achievements over the past three years. (Tell us about some of your experiences in the area of dance or any other area you have been participating and feel proud to share.)
  4. A statement indicating why you would be a good candidate for the Premier Dance Academy.
  5. Please indicate if you have had or have any injuries of physical restrictions. This is just for our information. It will not preclude the student from being accepted.
  6. Please ensure you provide (scan) a copy of the student’s most recent report card to dnelson@wvschools.ca.
* Attach document here:

Please click "Submit Registration" button only ONCE and wait...