Private Lesson Registration Form

Social Dance Private Lesson Request
Private lessons at Northern Plains Dance are scheduled based on instructor availability and are offered in Social Dance styles only (i.e. Waltz, Salsa, Two-Step, etc).

Date/Time is not final until confirmed with NPD.

Payment is required to reserve private lesson date/time. Private lessons include 1 hour of instruction in a specific style of dance for a base price of $100.00.

Additional lesson times or requests (such as choreography or music editing) will result in additional fees.

Contact NPD at dance@northernplainsdance.org or 701.530.0986 if you have questions about your lesson.
Full Name*

PrefixFirst NameLast Name
Dance Partner (if applicable)

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
How did you hear about us?*
Would you like more information on Northern Plains Dance's programming?

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Section II: Lesson Specifics
Tell us a little bit about what you are looking for:
Song (if applicable):
If using a specific song, you must provide NPD with a copy of the song on CD or MP3 prior to the lesson time. Song choice may affect the dance style learned during the private lesson.
Style (if applicable):
If you are looking to learn a specific dance style, please let us know.
1st Choice of Date/Time

MonthDayYear
DateHourMinutesAM/PM Option
1st Choice of Date/Time (Must be different than above)*
2nd Choice of Date/Time (Must be different than above)*
3rd Choice of Date/Time (Must be different than above)*
2nd Choice of Date/Time

MonthDayYear
DateHourMinutesAM/PM Option
3rd Choice of Date/Time

MonthDayYear
DateHourMinutesAM/PM Option
NPD will contact you to finalize the date/time of your lesson. $100 base fee is required to reserve your date and time. All lessons are 1 hour in length unless special arrangements have been made.
If you have a coupon code, please enter it here.
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Social Dance Private Lesson Request

Section II: Lesson Specifics