Name of Event *

Event Sponsor *

Name of the instructor requested to conduct the event workshop *

Date of Event *

Event Start Time *

Duration of Event *

Requested Instructor Arrival Time *

Location of Event Address *

Location of Event City *

Location of Event State *
Select State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Instructor Parking Location *

Is there a fee to park? *
Select Yes No

Event Contact Name *

Event Contact Phone *

Event Contact E-mail *

Is the event contact the same as the on-site event contact? *
Select Yes No

Event Workshop Type *
Select Dance Fitness Combination Workshop

Is there an overall theme for the event? *

Music Type (select all that apply)
Hip Hop
Latin
Reggae
Popular

Estimated number of participants *

Estimated Gender % *

What is the estimated average age of the participants? *

Estimated Participant Experience Level % *
Select Beginner Intermediate Advanced

Are the participants English speaking? *
Select Yes No

Is the event open to the public? *
Select Yes No

If so, what is the cost to participate in the event?

Requested Instructor Attire *

Is there an attire color theme? *

Will the room have mirrors? *

Type of Music Plug-in *

What is the fee amount paid to the instructor? *

What is the payment method? *

When will payment be made? *

Are there any special instructions or requests for the instructor?