Wufoo
Encore Performing Arts Center
Dance Application Form: 2011-2012
Instructions:
Applications for dancers are considered based on space availability and forms will be processed as they are received by e-mail, mail or hand-delivery on a first come, first served basis. Please complete this entire application (one form for each dancer). To complete your application and secure registration, please make arrangements to stop by the facility with your dancer for a uniform fitting and to provide tuition payment.
Registrations are not complete until Sections I-V of this application are entirely completed (with an electronic signature) and the tuition has been received or payment arrangements have been made.
For more information, please call (203) 210-7155 or visit www.FleurdeLisAcademy.com
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Section I: Dancer Information
2
Section II: Parent or Guardian Information
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Section III: Emergency Contact Information
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Section IV: Statement of Understanding
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Section V: Class Selections
Section I: Dancer Information
Please choose one of the following:
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Returning FDL Dancer
New to FDL Family
Name
*
First
Last
Age
*
Date of Birth
*
MM
/
DD
/
YYYY
Gender
*
Female
Male
Academic Grade
*
Academic School
*
Email
*
Cell/Other
*
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Please list previous dance, theatrical and fine art experience:
*
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5
Do Not Fill This Out