Dancer Application

Stage Name:
Real Name:
Address:
City:
State:
Zip:
Age:
Date of Birth:
E-mail Address:
Home Phone:
Pager/Cell:
Use Discretion when Calling : Yes No
Previous Dancing Experience (if Any)

List Clubs:

1652 Wolcott Rd. (route 69) • Wolcott, CT 06716
203.879.4287
Open 7 Days Noon - Close