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CityDance 2023/2024 Application
This form must be completed to receive information about our CityDance Auditions. For questions about this form, please email
sberrylee@usaibc.com
or call 601-355-9853
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* Indicates required question
Email
*
Your email
Child's Name (First & Last)
*
Your answer
Child's Birthday
*
MM
/
DD
/
YYYY
Jackson Public School, Charter School, Or Virtual School Attending (ex. Obama Magnet, Casey, etc)
*
Your answer
Current Grade in school
*
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
Other:
Parent/Guardians Full Name
*
Your answer
Phone number
*
Your answer
Please list any additional parents/guardians email addresses
Your answer
Please fill in the child's clothing size.
XS-Child
S-Child
M-Child
L-Child
XL-Child
XS- Adult
S-Adult
M-Adult
L-Adult
XL-Adult
Shirt
Pants
XS-Child
S-Child
M-Child
L-Child
XL-Child
XS- Adult
S-Adult
M-Adult
L-Adult
XL-Adult
Shirt
Pants
Child's Shoe size
Your answer
Mailing Address
Your answer
Zip Code
Your answer
Please list any siblings also auditioning for the program.
Your answer
Has your child ever taken dance lessons before? (Previous experience is NOT required)
Yes
No
Clear selection
If yes, where did your child take lessons?
Your answer
Has your child been accepted into the CityDance Program before?
Yes
No
Clear selection
If yes, What year?
Your answer
Any additional information or comments we need to know about your child?
Your answer
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