UnbanFertilityDancer

Online Application

Upon acceptance to the program, we will apply the non-refundable, non-transferable deposit amount towards the workshop fee and email you to confirm your acceptance. For those paying by check, please send check to “PoleCat Power” for the $500 non-refundable, non-transferable deposit upon submitting your application. Your application will not be processed without the check. However, your check will not be cashed until acceptance. If you are not accepted to the program, your check will be destroyed or returned to you.

Please note:
- Your Deposit is charged upon acceptance in the workshop. NO EXCEPTIONS.
- The deposit is nontransferable/non-refundable.
- Full tuition is due 2-weeks prior to the workshop commencing.
- Complete Workshop Fee is nonrefundable, nontransferable 2 weeks prior.
- If we don't have full payment by 2-weeks prior to the workshop, you risk losing your space.
- We reserve the right to cancel a workshop at any time.

$500.00 deposit

Date:
Full Name:
Workshops & Dates Requested :
Color Photo or Video Clip
$500.00 deposit
Photocopy of current photo I.D
Address:
City, State, ZIP:
Email:
Website:
Daytime phone:
Evening phone:
Occupation:
Age:
Marital Status:
Education level:
EMERGENCY CONTACT
Name:
Relation:
Phone:
Please answer all of the following questions to the best of your ability. You may also Copy/Paste these questions into another document and fill it out.
Please list any previous exotic dance/pole dance experience (length of time, specific teachers, types of exotic dancing/pole dancing, professional or not)
Why are you interested in our Instructor Training Workshops? How did you hear about the workshops?
What are your expectations for this training? What do you hope to take home from it?
Please explain your willingness to be fully committed and attend 100% of the training workshop.
List any other things you think we might find interesting or should know about you.
Please list the type, duration and style of movement based classes you teach (yoga, fitness, dance, gymnastics, martial arts…), the average number of students you have, and length of time you have been teaching.
Where do you teach? Name, location and contact info.Also, please provide your website address if you have one.
If you have never taught movement before, what makes you want to teach pole dancing? Why do you think you would be a good instructor?
Why do you enjoy teaching movement classes?
Please give us two (2) personal references, not related to you:
Contact 1
Occupation:
Phone/email:
Relation to you:

Contact 2
Occupation:
Phone/email:
Relation to you:

I have read and understand the above terms and requirements. To the best of my knowledge, all of the above is true and correct.
Online Signature of Applicant and Date