AICD - Adult Ballet assessment Program Enrolment Form

AICD - Adult Ballet Assessment Program Expression of Interest Form
Full Name*

First NameMiddle NameLast Name
Email*
example@example.com
Phone Number*
Birth Date

MonthDayYear
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Emergency Contact*

First NameLast Name
Phone Number Of Person To Contact In Case Of Emergency*
Please enter a valid phone number.
AICD Level selection Semester 2 - Commencing the week of Saturday 19 July, 2025.*

AICD Level 1- Tuesday 8pmAICD Level 2 - Wednesday 8pmAICD Level 3 - Monday 8pmADIC Level 3a. (Daytime) Wednesday 12pmAICD Level 4 - Thursday 8pmAICD Level 5 - Thursday 8pmI am not sure what level is appropriate for my experience.
Preferred Payment type*
Please provide any information about injuries or restrictions.
Please provide any information about your dance history and level as an adult ballet dancer. We love to know your goals and what you have achieved so far.
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AICD - Adult Ballet Assessment Program Expression of Interest Form