Confidential
Fees Paid: Y / N
Page 1
7/27/2016
Fee paid by: ________________________________
Southside Dance Company Dance Information Form
Choreographer Name(s):
Name of Dance (Correlated to theme: NOT song title)
Type of Dance:
_____
Name of Song: (MUST be different from name of dance)
Name of artist:
_____
Number of Dancers:
Length of song (CUT): _________
Please provide any specific requests you have for your dance (ex., I need 4 who can do
fuetés. I need 3 boys who can do lifts. I need platforms built for my dance.)
Costume Desired: (may be continued on back, if needed)
Catalog/Web Site:
Page Number:
Description:
Color:
___
Item Number:
Price:
Small ______
Medium ______
Large ______
--------------------------------------------------------------------------------------------------------------------Catalog/Web Site:
Page Number:
___
Description:
Color:
Item Number:
Price:
Small ______
Medium ______
Large ______
--------------------------------------------------------------------------------------------------------------------Catalog/Web Site:
Page Number:
___
Description:
Color:
Item Number:
Price:
Small ______
Medium ______
Large ______
--------------------------------------------------------------------------------------------------------------------The decision of acceptance will be made by the Sponsor and Instructor.
A list of accepted dances will be posted within one week of the last date of auditions.
Choreographer Signature
Dance Accepted: Y / N
Date
219551555
Music Provided (Cut): Y / N