Expression of Interest Form

Please fill out the information below.		* Required information

Student 1
Last name *		Classes for students under 12	Creative Tots Creative Dance Tinies Ballet/Jazz Tinies Tap Pre-Primary Ballet/Jazz and/or Tap
First name *
Date of birth *
Preferred days	Monday Tuesday Wednesday Thursday Saturday	Classes for teen or adult students	Jazz Tap Ballet Hip Hop Acrobatics Contemporary/Lyrical

Student 2
Last name		Classes for students under 12	Creative Tots Creative Dance Tinies Ballet/Jazz Tinies Tap Pre-Primary Ballet/Jazz and/or Tap
First name
Date of birth
Preferred days	Monday Tuesday Wednesday Thursday Saturday	Classes for teen or adult students	Jazz Tap Ballet Hip Hop Acrobatics Contemporary/Lyrical

Student 3
Last name		Classes for students under 12	Creative Tots Creative Dance Tinies Ballet/Jazz Tinies Tap Pre-Primary Ballet/Jazz and/or Tap
First name
Date of birth
Preferred days	Monday Tuesday Wednesday Thursday Saturday	Classes for teen or adult students	Jazz Tap Ballet Hip Hop Acrobatics Contemporary/Lyrical

Student 4
Last name		Classes for students under 12	Creative Tots Creative Dance Tinies Ballet/Jazz Tinies Tap Pre-Primary Ballet/Jazz and/or Tap
First name
Date of birth
Preferred days	Monday Tuesday Wednesday Thursday Saturday	Classes for teen or adult students	Jazz Tap Ballet Hip Hop Acrobatics Contemporary/Lyrical

Contact information
Street address 1 *		Home phone *
Street address 2		Work phone
Suburb *		Mobile 1 *
State/Territory *		Mobile 2
Postcode *		Email *