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First Name
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Last Name
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Maiden Name (if applicable)
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Years of participation in Reif Dance: (for example, 1995-2001)
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Email Address
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Mailing Address
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City
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State
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Zip
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How has Reif Dance impacted your life? (Comments may be used for publicity)
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Upon completion of my instruction with Reif Dance I have:
pursued further dance instruction.
continued to perform as a dancer.
danced professionally.
taught dance.
choreographed dance.
enrolled my children in dance classes.
Other:
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