Ballet Hispánico Community Arts Partnerships General Inquiry Form

Primary Contact First Name *

Primary Contact Last Name *

Group/Organization (if applicable) *

Job Title/Position

E-mail Address *

Phone Number *

Website

Street Address (Organization) *

City *

State *

Zip Code *

Which of our Community Programs are you interested? (Check ALL that apply) *

Which of the following dance forms are you interested? (Check ALL that apply) *

Flamenco	Latin Social Dances (Salsa, Bachata, Merengue)
Argentinian Folk and Traditoinal Dances (Tango, Chacarera)	Latin American Folk Dances
Afro-Caribbean Dance Forms	Other Other

Potential Starting Date: *

Preferred Day(s) of the Week

Preferred Time(s) of the Day

How many number of sessions (for residencies, master classes, workshops)?

How many people/students would participate in the program (by estimate)? *

Grade/Year Level of Participants *

Where would the program take place? *

Please share any additional inquiries:

How did you hear about Ballet Hispánico's Community Programs? (Check ALL that apply) *