Print out the application form, fill it in and enclose the evaluation from your present dance teacher and any other particular requests or objectives. This documentation can be sent either by e-mail , post, or fax. Please answer all questions. All fields marked with a * are required and must be completed. Applications must be received at least 4 weeks prior to the start of the course to guarantee the best seats for the performances and placement in the dance school chosen.

Once your application has been received you will be give a reference N° that you will need to quote on all correspondence, e-mails or when contacting us by telephone.

For your convenience if you prefer, you can send us your application form securely on-line. We also accept cheques and bank transfers.

First Name*

Last Name*

Age:*

Passport N° *

Home Tel N° (country code first)

Work Tel N° (country code first)

Mobile Tel N° (country code first)

Fax N° (country code first)

E-mail

Address:*

Next of kin Address and Tel N° (if different from above)

Starting date:* (please tick)

4th January

2nd February

4th May

7th June

6th July

2nd August

7th September

Choice of dance school:* (please tick)

Alvin Ailey:

Erik Hawkins:

Jose Limon:

Lynn Simson Jazz School:

Joffrey Ballet School:

Mercie Cunningham:

Marha Graham:

I have decided to register for this course because:*

Contact telephone number in New York:*

SECTION 4. PAYMENT DETAILS

Pay to:

Totalnannies.com

Payment for:

Amount:

£ 99.00

Payment for:

Registration Fee

Amount:

£ 172.00

Total due:

£271.00

I wish to pay for the registration fee by (please tick)

 Bank Transfer:    Cheque: 

 in the Dance/English Program

Signed:

Date:

Great Britain

France

Germany

Ireland

Italy

Spain

Switzerland

USA

Japan