Weekly Teen Contras Scholarship
By completing this application for full scholarship funding to attend weekly contra dancing in Belfast, you are committing to attending at least 10 of the sessions. (Thursday evenings, 6:00 - 8:15 pm at the Belfast Dance Studio, for 18 weeks, from January 18 through May 17.) Scholarship funding is possible thanks to grant funding for the Belfast Flying Shoes outreach program. Questions or info contact Chrissy Fowler 338-0979 or ktaadn_me@hotmail.com
Name (first & last) *
Your answer
Age *
Your answer
Email* *
Your answer
*Is this your personal email, or someone else's (if not yours, whose?) *
Your answer
Phone** *
Your answer
**Is this your personal phone number, or someone else's (if not yours, whose?) *
Your answer
List 2 or more reasons why you want to attend these weekly contra sessions. *
Your answer
List your top 3 priorities for what you want to do / cover / address / experience / explore over the course of the ten weeks of dancing together. (These can be specific or general. As feasible, we will try to incorporate each request.) *
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service