seniors 2007

Director
Cindy Dalzell BATD

The Dance Factory
26 Years in Meadowvale
6535 Millcreek Drive, Unit 73
Mississauga ON L5N 2M2
(905) 821-2110

New Student Inquiry Form

Submit on-line inquiry form below.
You will be contacted shorty with weekly class and fee schedules.

(please complete one per student)

Student Information

Family Name
First Name
Date of Birth
Street Address
City/Town
Postal Code
E-mail Address*
Home Phone
Daytime Phone
Mothers Name
Fathers Name
Previous Dance Experience (if any)
Number of Years
Studio
Select one or more classes
Tap	Jazz
Ballet	Acro
Hip Hop	Lyrical
Other Class
Additonal Comments: