Dancin Power Youth Program Application
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Contact information
First Name: *
Last name *
City *
State *
Phone number *
E-mail *
Preferred contact method *
Required
Tell us what is your time zone *
Required
How did you hear about Dancin Power? Was it through Facebook, Instagram, Twitter, LinkedIn, a friend, Google search or other? Would you please let us know? Your feedback will help us improve our awareness.
Would you please tell us more about your connection with dance and health?
1- How many years of dance experience do you have? (numbers only please) *
3- What are the dance styles you have trained so far? *
Required
4- Which Dancin Power Youth Program are you interested in applying for today? *
4- Tell us the main reason you're applying today: *
5- To be a Dancin Power Teen Ambassador, or a Dancin Power Jr. Teacher, we ask that you please make a commitment to devote 2+ hours per month to the program. Are you going to be able to do that? If yes, please initial below and ask one parent to do the same. *
6- What other languages do you speak, if any? *
7- What is your nearest children's hospital? *
8- If selected to the Dancin Power Youth Programs, there is a 1-Year Commitment Requirement. Please ask your parents to  type their name and date below to confirm their understanding on what it means to commit to the uphold agreement.  *Parents authorization required. *
If you feel that we forgot to ask you something that you'd like us to know about you, please enter your question and answer below.
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