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12
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1
Full Name
First Name
Last Name
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2
Email Address
example@example.com
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3
Phone Number
Please enter a valid phone number.
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4
Occupation
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5
What is your current Income level?
NOTE: This is NOT REQUIRED. The information received will only be used to adjust the pricing for future customers based on their income
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10,000
+100,000
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6
Preferred/Known Dance Styles
Ballet
Contemporary
Hip Hop
Jazz
Tap
Latin
Ballroom
Street
Salsa
Merengue
Bachata
Mambo
West Coast Swing
Hustle
Waltz
Tango
Argentine Tango
Rumba
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7
Dance Experience
Explain your previous dance experience
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8
Rate your Dance abilities:
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Fluidity, Movement, Visible enjoyment, comfortability, etc.
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9
Rate your Dance confidence:
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Movement, rhythm, posture, enjoyment, etc.
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10
How much room do you have at your home?
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< 500 SqFt
> 3,000 SqFt
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11
Save the date for our First Dance...
*
This field is required.
Schedule a consultation where we share, dance, and live
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12
What emotions better explains how you are feeling about this experience?
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This field is required.
Ecstatic/Extremely Excited
Apprehensive
Open Minded
Nervous
Eager
Calm
Indifferent
Not Sure
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