Cinderella LP Application Form

Please use this form to apply for a Cinderella Local Participant Role

I am applying for a Local Participant Role in Cinderella:
Choose your Performance City (click all that apply)*
- Prince Albert, SK
- Vernon, BC
- Saint John, NB
- Summerside, PE
- Halifax, NS
ABOUT THE STUDENT
Student name:
First Last
Address
Street Address Address Line 2 City Province Postal Code
Telephone Number
Mobile Number:
Parent/Student Email [primary contact]*
Enter Email Confirm Email
Student Email [optional]
Enter Email Confirm Email
Gender*
- Female
- Male
- Non-Binary
- Prefer not to say
Pronouns
Date of Birth
Month
Day
Year
Your Age Today:
Your Height (inches):*
Your Waist (inches):*
Your Chest (inches):*
ABOUT MY TRAINING
Current or most recent dance school name:*
Dance School City and Province:*
City State / Province / Region
Dance School Contact Name:
Dance School Phone Number:
Dance School Email:
The above teacher will complete a recommendation form to endorse my application*
- Yes
- No
Permissions
Would you like to receive information about Jörgen Dance programs in your area?*
- Yes
- No

I am applying for a Local Participant Role in Cinderella: