DPC 2020 Application Form

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APPLICATION FORM DANCE PE CHANCE

NAME OF DANCE INSTITUTION:*

NAME OF CHOREOGRAPHER:*

ADDRESS:*

CELL PHONE:*

HOME PHONE:

EMAIL:*

NO. OF PARTICIPANTS:*

NAME OF PARTICIPANTS: KINDLY FILL IN THE INFORMATION IN THE ENCLOSED FORM CATEGORY:*

SONG NAME:*

1.

FILM:*

1.

SONG NAME:

2.

FILM:

2.

SONG NAME:

3.

FILM:

3.

SONG NAME:

4.

FILM:

4.

DURATION:*

(NOT ALLOWED MORE THAN 5 MINS)

ITEM BRIEF DESCRIPTION:*

COSTUME COLOR:*

MANAGER NAME:*

MANAGER CONTACT PHONE:*

EMAIL:*

SPECIAL REQUESTS:

LIST OF PARTICIPANTS

(IN ALPHABETICAL ORDER BY LAST NAME)

SR
PARTICIPANT'S NAME
DATE OF BIRTH
AGE on 1/25/2020
NOTE :- If you want to add more participants in the above list kindly send an email to saurinparikh@fianynjct.org in the same format which you have received in your email after submitting this form.
I hereby acknowledge and confirm to have read and understood all the aforementioned rules and duly consent to abide by them to the best of my knowledge and ability.

I Agree Terms & Condition

Make Check payable to Federation of Indian Associations NY, NJ, & CT and Mail Check To: Saurin Parikh, 4 Algiers Street, Plainview, NY 11803.