JUNIOR MEMBERSHIP APPLICATION

            NAME_____________________________________________________________              DATE________________________

            ADDRESS:_______________________________________________________________________________

            CITY___________________________________          STATE:________________________        ZIP:_____________________

            PHONE:(____)___________________________           BIRTHDATE:_______/________/_________

            AGE:__________            EMAIL:_____________________________________________________

            DMM MEMBER:__________________________________________________________________________________

            STUDIO NAME:__________________________________________________________________________________

            STUDIO ADDRESS:_______________________________________________________________________________

            CITY:___________________________________            STATE:________________________        ZIP:____________________

            STUDIO PHONE:(____)____________________        ARE YOU CURRENTLY A STUDENT TEACHER?  YES____    NO____

            TYPES OF DANCE STUDIED:______________________________________________________________________________

            _______________________________________________________________________________________________________

            ___________________________________________________# YRS STUDIED______________________________________

            ATTACH A BRIEF RESUME AND AN ESSAY EXPLAINING WHY YOU WOULD LIKE TO BE A JUNIOR MEMBER
             & WHAT YOU WOULD LIKE TO GAIN FROM MEMBERSHIP IN THIS ORGANIZATION.

            _____________________________________________                        ___________________________________________
                                DMM MEMBER SIGNATURE                                                                                                        APPLICANT SIGNATURE

            Applications must be postmarked by December 1, 2009.
            to:  Junior Membership, c/o Tammy Weadock,  8657 Dalton Ct., Onsted, MI 49265

            Cell:  (517) 605-7336                        email:  tammy@domsys.com