Name *

First Name

Last Name

Phone

(###)

###

####

What is your preferred form of contact? *

Email

Text

Call

Other

Ideally, how often would you want to teach at Stomptown? *

I'd just like to try it once and see how it goes.

No more than 1-2 times a year.

3-6 times a year.

As often as I can!

Finally, please indicate your willingness to follow the expectations for Stomptown line dance instructors by checking the box next to each of the following statements. *

I agree to review and adhere to the guidelines and expectations for Stomptown line dance instructors.

I agree to respond to communication from the Stomptown board and line dance committee within a reasonable time frame.

I agree to be open to feedback on my instruction and do my best to incorporate feedback into future instruction.