Premier Dance Academy
(* indicates required field)
(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
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
(If different from above)
Student's Current School
(ie: West Vancouver, North Vancouver, etc.)
School Attending this September
(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
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.
Dance Exams Passed (Indicate style, association & grade).
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.)
A statement indicating why you would be a good candidate for the Premier Dance Academy.
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.
Please ensure you provide (scan) a copy of the student’s most recent report card to
* Attach document here:
Please click "Submit Registration" button only ONCE and wait...