School Program Request Form
Bradlee Lathon, Program Manager
Full Name
*
First Name
Last Name
School Name
*
Role at School
*
Please Select
Principal
Arts Liaison
Staff/ Faculty
Other
Email address
*
example@example.com
New Partner, Existing. or Past Partner
*
Please Select
New Partner
Existing Partner
Previous Partner
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Mobile Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Method of Contact
Please Select
Phone Call
Mobile Phone Call
Email
About Your School
It takes less than 5 minutes to help us prepare for your needs. Most fields are required. Thank you for your patience.
What type of dance program interests you?
*
In-School
After-School
Day of Dance
Performing for Purpose
Family & Community
What grade levels would you like to include
*
Pre-K
K-2
3-5
6-8
9-12
Mix
What DAY(S) of the week would you like the program to take place?
*
Monday
Tuesday
Wednesday
Thursday
Friday
What Start Date?
*
-
Month
-
Day
Year
Date
What End Date?
*
-
Month
-
Day
Year
Date
What STYLE(S) of dance are you most interested in for your school?
*
African
Ballet
Creative Movement
Hip Hop
Latin
Undecided
Questions and Comments, or Best Time to Contact You.
Submit
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