Request edit access
Private Lesson/Coaching - Dancer Information Request
Thank you for your interest in Kerollis Educational Dance Services.
Please fill out the below information and send requested footage for consideration.

Once approved, first lesson fee must be paid to begin scheduling.
Sign in to Google to save your progress. Learn more
Dancer's Full Name: *
Pronouns: *
Date of Birth: *
MM
/
DD
/
YYYY
Guardian Email: *
Guardian Name *
Put your name again if this does not apply.
Current Year-Round Training Program: *
Please provide name of school/program
Training Experience (years of ballet, contemporary, other styles): *
Requested Service/Style: *
Please provide what you would like to accomplish during the private lesson.
Current Dance Goals: *
*Please provide performance/rehearsal footage of classical variation & contemporary solo plus 30 seconds of improvisation. *
Footage should be within past 6 months and sent via Google Drive or Youtube link. 
If footage is unavailable, please film adagio, pirouettes, & grand allegro in center. 
Improvisation may be filmed in-studio, at-home, or outdoors.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report