Membership Application

ADFP Membership Application
Your Name*

First NameLast Name
Your Email*
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*
Date of Birth*

MonthDayYear
Date
Please Upload A Self-Portrait Photograph*

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Member ID (If applicable)
School Name (If applicable)
School ID (If applicable)
I am the School Principal

YesNo
School Principal Name (If applicable and not yourself)
School Address (If applicable)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Freestyle Qualification Level*
Association of Freestyle Qualification*
Date of Freestyle Qualification*

DayMonthYear
Date
Upload Copies of Qualifications

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References are required from 2 ADFP current Full Members to vouch for you professionally. The ADFP members must be from 2 different ADFP registered schools and can not be from the school you teach at or from your previous ADFP teacher whilst an amateur. The referee must have known you professionally for a minimum of 12 months or as an amateur.
Referee 1 (two ADFP members from different schools required. Ensure you have the referee’s permission first)*
Referee 2 *
Ensure you have the referee’s permission before submitting this form. The referee’s listed will be contacted by the ADFP office for their reference in writing.
DBS (under 3 years old)*

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Safeguarding Certification*

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Have you ever been convicted of any criminal offence?*

YesNo
If yes please give details below
Have you been refused membership from any other Dance Association?*

YesNo
If yes please give details below
Have you been refused an application for a DBS?*

YesNo
If yes please give details below
Enhanced Disclosure*

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Enhanced Disclosure References
Please summarise a brief history of your professional dance teaching career and in particular your Freestyle experience. *
I hereby agree that by paying my membership subscriptions I will abide by the current rules and constitution of the ADFP and subsequently any amendments that are imposed by the ADFP association.
Signature*

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Payment*

Adjudicating Membership

£65.00

Student Membership

£35.00

Non - Adjudicating Membership

£45.00

Total

£0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

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ADFP Membership Application