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Shushi Armenian Dance Ensemble Membership 2020-2021
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Email
*
Your email
Last Name
*
Your answer
First Name of Member 1
*
Your answer
Date of Birth of Member 1
*
MM
/
DD
/
YYYY
Email of Member 1
Your answer
Mobile Number of Member 1
Your answer
Any prior dance experience?
*
Yes
No
If yes, please explain
Your answer
First Name of Member 2
Your answer
Date of Birth of Member 2
MM
/
DD
/
YYYY
Email of Member 2
Your answer
Mobile Number of Member 2
Your answer
Any prior dance experience?
Yes
No
Clear selection
If yes, please explain
Your answer
First Name of Member 3
Your answer
Date of Birth of Member 3
MM
/
DD
/
YYYY
Email of Member 3
Your answer
Mobile Number of Member 3
Your answer
Any prior dance experience?
Yes
No
Clear selection
If yes, please explain
Your answer
First Name of Member 4
Your answer
Date of Birth of Member 4
MM
/
DD
/
YYYY
Email of Member 4
Your answer
Mobile Number of Member 4
Your answer
Any prior dance experience?
Yes
No
Clear selection
If yes, please explain
Your answer
Mother's Name
*
Your answer
Mother's Email
*
Your answer
Mother's Mobile Number
*
Your answer
Father's Name
Your answer
Father's Email
Your answer
Father's Mobile Number
Your answer
Home Street Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
Home Telephone
Your answer
Work Telephone
Your answer
Will you be willing to help or get involved in any Shushi activity?
*
Yes
No
If yes, in which Area?
During Rehearsals
During Performances
Costume Production
How did you hear about Shushi Dance Ensemble?
*
Your answer
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