Your Contact Information
Name:
*
E-mail:
*
School Name
*
School or Home Phone:
*
Cell Phone
Address:
*
City:
*
State
*
Zip code:
*
Details Regarding Clinic
Choose Clinic Duration
*
Please Select
Workshop (0-8 hr)
Mini-Camp (8-16 hr)
Camp (16-24 hr)
Phone Consultation
Other (specify)
"other" from above:
Start Date of Clinic
-
Month
-
Day
Year
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1
2
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4
5
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8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Ending Date of Clinic
-
Month
-
Day
Year
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1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Have you used a Dynamic Marching Clinician in the Past?:
*
Yes
No
Do you wish to request a specific clinician or consultant?
What type of consultant do you wish to hire?
*
DM PRO certified $$
DM Certified $
No Preference
Choose those skills that you wish your consultant to have:
*
Visual Fundamentals
Music Fundamentals
Technology
Drill Teaching / Cleaning
Color Guard Fundamentals
Percussion Fundamentals
Guard Choreography
Band Body Choreography
Additional Information:
Should be Empty: