Student Registration Form

Sanjeev Jimmy International School Of Indian & Bollywood Dance
INDIA – ENGLAND – CANADA
www.sanjeevjimmy.com
[email protected]
India +91 9888182234 , England  +44 7838543000

    Name*

    Email*

    Mobile*

    Sex*

    MaleFemalePrefer not to say

    Date Of Birth*

    Where You Want To Join SJISD Classes*

    IndiaEnglandCanada

    Have You Ever Joined Any Dance Class?

    YesNo

    Motive Of Learn Dancing

    SociallyHobbyFitnessProfessionally

    Any Health Issue ?

    YesNo

    If Have Health Issue Please Brief Your Problem*

    Choose Your Package

    Regular Membership ( 6 weeks )Silver Membership ( 12 weeks )Gold Membership ( 24 weeks )Platinum Membership ( 36 weeks )

    Tick On Selected Category

    Basic Course For BeginnersImprover Course For IntermediateAdvance CourseDance Workout & Social Dance ProgrammeBollywood Dance ClassesIndian Folk Dance ClassesBollywood & Indian Folk Dance ClassesFamily Wedding ChoreographyCouple Dance ClassStage Performance PreparationAny Other

    Please Mention If Any Other*

    Tick On Preferred Dance Forms

    Free Style Bollywood DanceIndian Folk DanceSocial DanceHip HopIndian ContemporarySalsaTheme & Concept Dancing

    Date Of Joining*

    Signature*

    Address*

    captcha