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"Quality Enrichment Programs for the Cruise Industry"
Phone: 305-931-1026 - Fax: 305-931-1132 - Email: Zammel@aol.com
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Dance Instructor Application Form

Please provide the following information:

Name (as it appears on passport)
Passport #/Expiration Date/Date of Birth
Partner's name (as it appears on passport)
Partner's Passport#/Exp.Date/Date of Birth
Street Address
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
Cell Phone
FAX
E-mail
Website Address
Languages Spoken

Select any of the following specialty areas:

Foxtrot      Swing      Mambo      Other    
Merengue     Polka      Hustle
Waltz        Freestyle  Electric Slide
Cha-Cha      Tango      Country Western
Rumba        Samba

Summarize your dance training:


Please provide emergency contact name, phone number, & relationship:

Please provide a short biography on why you are qualified to instruct:


In a separate email, please attach a recent photo, a character reference and a letter of evaluation of teaching ability.

Revised: 05/29/10

To Sea With Z -- Call 1-305-931-1026 -- Email: Zammel@aol.com
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