Dance Summer Intensive 2019

First Name

Middle Name

Last Name

Birthdate

Gender

Mailing Address

Country

Street

City

Region

Postal Code

Email Address

Phone

Name of High School

CEEB Code

Current Educational Standing in Fall 2019

Anticipated Entry Term for College

Name of Current Dance School

Address of Current Dance School

Current Dance Training (List techniques and years of training)

Parent/Guardian Name

Parent/Guardian Relationship to Student

Parent/Guardian Address (if different from above)

Parent/Guardian Email

Parent/Guardian Phone

How did you hear about Marymount Manhattan College?

Program Type

Two day, program $400 [Saturday, July 6 & Sunday, July 7]

One day, program $300 [Saturday, July 6]

One day, program $300 [Sunday, July 7]