Form Test | Dueling Arts International

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Personal Details

First Name(Required)

Last Name(Required)

Email(Required)

Phone(Required)

Address

Address(Required)

Street Address

City

State / Province / Region

ZIP / Postal Code

Country

Demographic Information

We collect this information for internal use only. It will not be shared with any outside persons or groups.

Racial Identity

Gender

Age

Access Needs

Special Access Needs

I do not have special access needs

I have special access needs

Please specifiy your needs below

Training Level(Required)

Instructor Referral

Needed for advanced training consideration

File

For advanced training consideration, we ask for an instructor referral. As an alternative, a pdf of your resume or documentation of relevant stage combat experience may be included here:

Accepted file types: pdf, Max. file size: 15 MB.

Do you need housing?(Required)

Yes

Special Accomodations

Dueling Arts International is committed to equitable and ethical inclusion. Are you in need of special accommodations?

Yes

Please list your needed accomodations here

Travel Details(Required)

You will be asked to provide your travel details one week prior to the first day of the workshop. Please respond with your commitment to provide specifics (flight arrival date and time, planned arrival by car, or local residence at workshop site).

I will provide details

Scholarship

Dueling Arts International offers scholarships based on financial need. If you wish to apply for one of the scholarships, you will be redirected to the application process after you submit this form. Sincere and thoughtful inquiries will be considered.

I would like to apply

Deposit

Secure your place in this course

Price:

Total

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Do NOT close the window or cancel the process unless you want to cancel your submission.
The process is considered complete when PayPal notifies you of payment success and you are redirected back to our website.
You do NOT need a PayPal account to make the payment. You may use a credit card through PayPal's interface.

How did you hear about this workshop?

Referral by an Instructor

Referral by a Friend

Social Media (Facebook or Instagram)

Workshop Flyer

Other

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