DPPAC Student Class Change and/or Withdrawal Form
Exit Survey
Student Name *
Your answer
Class Names, Days and Times *
Your answer
List Reasons for Withdrawing *
Your answer
Teacher(s) was/were cheerful, encouraging, inspiring, prepared, organized, created a safe and supportive environment and was on time. Teacher(s) dress and demeanor was/were appropriate for age and style. Maintained appropriate order and respect. Makes corrections and requests in a clear and professional way? *
Your answer
Class placement was appropriate for student's age and ability? *
Your answer
Teacher(s) provided adequate warm up, fundamentals and footwork, strength building and appropriate challenge skill building exercises and drills are evident. Clear explanation of technique Choreography appropriate for age and level? *
Your answer
Teacher(s) communicated pertinent information, receptive to feedback from students/parents? Teacher/Director are available for phone calls or conferences Important dates and deadlines are communicated in a clear and timely way? *
Your answer
Office staff is helpful and friendly? The facility is clean and pleasant and Dance Shoppe is useful and convenient? Management team is organized, available and professional? *
Your answer
What could we have added or provided that would make your participation at DPPAC even better? *
Your answer
Would you recommend DPPAC to a friend or family member? If no, please let us know. *
Your answer
Method of Payment *
Please indicate date you notified DPPAC *
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Please indicate whether you notified us by *
As stated in our policy and procedure agreement, your signed copy on file with us, online parent portal agreement, as well as our electronic receipts to discontinue any lessons, 30 days notice prior to the next billing cycle on the 1st of the month must be given. A credit for makeup classes is hereby issued for any unused tuition fees and may be used at any time for any of our programs. registration fees are nonrefundable. Refunds may not be given on any payments that are made for tuition, competition fees, costumes, dancewear, photographs, DVD's, recital tickets, apparel or in advance to hold class placement. DPPAC reserves the right to hold any costumes paid for in advance for any unpaid balances. All auto-debit ACH (checks) or automatic debit or credit card charges will be stopped as of the following month once this form is received by our accounting department. Please indicate date 30 days from today's date that your automatic payment will stop. *
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Signature of Parent/Student (Please Type Full Name) *
Your answer
We are sorry to see you go. We hope that we served you and your family well over the past year(s). We look forward to seeing you again if future lessons are needed in any other facets of the performing arts. Thank you for giving us the opportunity to teach your child/children. All the best, Jennifer, Wendy and Staff
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