New Student Interest Form

New Student Interest Form
Today's Date

MonthDayYear
Date
Parent Contact Information
1st Parent's Name*

First NameLast Name
1st Parent's Phone Number*

Area CodePhone Number
1st Parent's Email*
example@example.com
1st Parent's Occupation & Employer*
2nd Parent's Name

First NameLast Name
2nd Parent's Phone Number

Area CodePhone Number
2nd Parent's Email
example@example.com
2nd Parent's Occupation & Employer
Mailing Address*

Street Address

Street Address Line 2

CityState

Zip Code
Student Information
Student's Name*

First NameLast Name
Student's Birth Date*

MonthDayYear
Date
Student's Age*
Gender*
Academic School*
Academic Grade*

Preschool/Pre-KKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeCollege
How many years of previous ballet training does the student have?*

NoneLess than 1 year1 year2 years3 years4 years5 years6 years7 years8 years9 years10+ years
What ballet schools has the student previously attended and/or is currently attending?*
How many days per week is the student attending ballet classes?*

1 day/week2 days/week3 days/week4 days/week5 days/week6 days/week7 days/week
Is the student currently training en pointe?*

YesNo
How long has the student been training en pointe?*

Less than 1 year1 year2 years3 years4 years5 years6 years7 years8 years9 years10+ years
Which studio location are you interested in?*

Ballet Hawaii HonoluluBallet Hawaii West
How did you hear about Ballet Hawaii?*

Referred by Current StudentFacebookInstagramGoogle/Internet SearchPrint AdvertisementAttended a Ballet Hawaii PerformanceOther
Which current student referred you?*
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