Dancercise Kids® Membership Application, Your Contact Information
Please tell us about yourself and the best way to reach you
Full Name
*
First Name
Last Name
E-mail
*
This is the primary means we use to communicate with you
Best Phone To Reach You
*
-
Area Code
Phone Number
Best Time To Call
*
The best day(s) and time(s) to reach you at this number
Street Address
*
City
*
State
*
Your Dance And Teaching Experience
We are excited to know about your experience.
Describe your experience working with children:
Describe your general teaching experience:
Describe your dance experience, including styles and length of training
Your Background
A condition of teaching children in most states is a full background check required by state authorities and clients. Is there anything you expect to appear on that check that might prevent you from working with young children?
Background Check
*
Nothing relevant on my record
There may be something relevant on my record
I do not wish to disclose at this time
Other
Your Interest And Availability
The vast majority of our classes take place at registered child care centers in the between 9am and noon on weekdays. There are a few afternoon sessions as well. Please indicate your level of availability and interest below
What membership level interests you the most?
*
Owner Operator
Business Builder (includes employee management)
Executive (includes additional administrative training)
Other
Available To Start
Immediately
2-3 Weeks
4+ Weeks
Uncertain
Transport
I have a reliable car
Why do you want to become a Member?
Acknowledgement And Other Information
I understand that this form is provided as a convenience to me as a prospective member of DK Business Systems and that, by typing my name in the box below and submitting the form, I consent to the use of any data submitted through this form by Dancercise Kids® and International Educational Resources Corp. for the purposes of considering me for membership. I further understand that completion and submission of this form does not constitute any obligation nor does it provide any guarantee of any contact with or from Dancercise Kids®. The information I have provided in this form is true and accurate to the best of my knowledge.
Please type your full name here to acknowledge the above statement
*
How did you hear about us?
*
Google Search
Facebook Ad
Dance Teacher Network
Dance Studio OWNERS
Referral
Who referred you?
T-shirt Size
*
small
medium
large
x-large
xx-large
Computer Type
*
PC
Mac
None
Any additional comments
Is there anything else you would like us to know?
Submit my application
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