West St. Louis County Chamber Dancing With The Stars
Application to Participate in the Competition as a Dancer

This event will take place November 7, 2015 at the Purser Center. To apply to participate in this event, please fill out this application completely. Thank you for your interest.

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First & Last Name *
Company Name *
Phone Number *
Email Address *
*
Are you applying to be a... *
Are you available November 7, 2015 for an all day event? *
Are you available for 20+ hours of rehearsal between June and November 7, 2015? *
Are there any weeks between June and November 7, 2015 that you are unavailable? *
What is your dance experience?
Why do you want to participate in the West St. Louis County Chamber Dancing with the Stars event? *
What Charity would you like to dance for and why? *
Please list the URLs for your personal and business pages on Facebook, Google+, Twitter, Instagram and You Tube accounts. *
Are you willing to sign a talent release, to be interviewed on television and/or radio and to have your image used in promotional materials for this event? *
Are you willing to become a member of the West St. Louis County Chamber of Commerce, if you are not already a member? *
Do you have access to rehearsal space? (not required to participate) *
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