Enrollment

Training Session (Check all sessions you plan to attend this quarter) *
Associate(Full Bronze) Certification Training - Class 1(Mondays) - Jan. 2-April 19, 2012 - Waltz & Tango Assoicate(Full Bronze) Certification Training - Class 2(Thursdays) - Jan. 2-April 19, 2012 - Foxtrot & Viennese Waltz Jr. Associate Certification Training Associate(Full Bronze) ReCertification Training
Prefix:
First Name: *
Last Name: *
Phone Number: *
Street Address: *
E-mail Address: *
Address Line 2:
City: *
State:
Postal Code: *
Country: *

How did you hear about us?
If referral, who referred you?
Please tell me about your dance background, if any: *
What is your main purpose in taking this course? *
Are you interested in a career as a ballroom dance teacher? If so, why? *
Please provide any additional information you want us to consider:
CBTA requires a $100 non-refundable deposit for each training class you have chosen to attend(up to $200). Please check one of the following: *
I have sent my credit card payment via www.Paypal.com, payable to michael.curtis@confidanceunlimited.com I have sent a check or money order payable to Confidance Unlimited to: Confidance Unlimited, 1213 Broadview Ave., Columbus, OH. 43212 I paid through the ConfiDance website (Google Checkout)

* Required	Create Email Forms

Teacher Certification Training Enrollment Form