DTL Academy Admission Form | Simonetta Ottone

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DTL® Academy Admisission Form

SECTION 1: Personal Information

Name

Surname

Date of Birth*

Month

Day

Year

Place of birth*

Nationality*

Identification*

Document No.*

Address*

Telephone*

Email*

Emergency Contact*

Emergency Telephone*

SECTION 2: Academic Path

Highest educational qualification achieved*

Study area*

Name of the Institute/University*

Year of graduation*

SECTION 3: Professional Experience and Dance

Years of dance experience*

Dance styles practiced*

Classical & Academic

Modern & Contemporary

Urban & Street Styles

Jazz & Show Dance

Social & Latin Dance

Ethnic

Somatic & Movement Research

Commercial & Performing Arts

Other

Do you have the 500-hour dance certification?*

Yes

No

In progress

Current occupation

English proficiency level*

Basic

Intermediate

Advanced

SECTION 4: Membership Options

Applicable Tuition Zone:*

Zona A (Africa & Middle East)

Zone B (Europe)

Choosing a payment plan*

Single Payment (Discounted)

2 Installments (Annual)

6 Installments (Every 4 months)

Workshop location preference*

Cairo - Egypt

Livorno - Italy

Bavaria - Germany

SECTION 5: Motivation and Health

Why do you want to become a DTL® therapist?*

Are there any physical injuries or medical conditions we should be aware of?*

SECTION 6: Documents to be attached

Copy of identity document/passport

Curriculum Vitae

Copies of certificates/diplomas

SECTION 7: Statement and Privacy

I confirm that the information provided complies with the company policy and terms of DTL® Academy. GDPR/Privacy Consent: Consent to the processing of personal data for academic purposes. View terms of use.

Select a date*

Your Signature*

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Via Strozzi, 40 - 57123 Livorno " Italy"

Tel. +39 347 1881957 - info@simonettaottone.it

© 2022 by Simonetta Ottone - Concept by Ash Tawfik

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