Registration
2020 Teachers Workshop Application
August 10 - 14, 2020

One application per student only. Application instructions are available on CPYB.org

NEW students should complete this form in it's entirety.

RETURNING students (those who attended or applied for a 2017-2019 CPYB summer program), click on the red link above to login to your Family Portal BEFORE completing this form for your existing account to be recognized. Please contact CPYB at 717.601.2840 if you need assistance with your username and password. Again, one application per student only.


Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Type*
Home Phone: Cell #: Work #:
Email:* (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
Emergency Contact (Include name, address, phone number, e-mail)*
 
 
Students entered below will be added to your family's account
 
Questions/Options:
How did you hear about the Teachers Workshop?
Do you have zero-one year of teaching experience?*
How many years have you been teaching?
CURRENT/MOST RECENT TEACHING EXPERIENCE: Name of School, include city and state.
CURRENT/MOST RECENT TEACHING EXPERIENCE: Age of students taught
CURRENT/MOST RECENT TEACHING EXPERIENCE: Start and end date of your current or most recent teaching employment
Do you have professional dance experience?*
PROFESSIONAL DANCE EXPERIENCE: Name of company, position and years
Please share any other pertinent information such as awards and/or other teacher/dance experience you'd like for us to know. (50 words or less)
 
Additional Information:
 
PROGRAM DATES & ACCOMMODATIONS
  (Show-Hide Details)
I've read the above and agree.
 
APPLICATION STATUS
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I've read the above and agree.
 
FINANCIAL POLICY
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I've read the above and agree.
 
PAYMENT AND REFUND POLICIES
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I've read the above and agree.
 
PUBLICITY RELEASE
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I've read the above and agree.
 
FINANCIALLY RESPONSIBLE PARTY
  (Show-Hide Details)
I've read the above and agree.
 
Enter your Full Name: *   
 
Other Questions/Comments:
 
Credit Card Verification:
   
Card Number: *  
Name as it appears on card: *
Nickname:
Card Expiration Month: *   Exp Year: *
Address Line 1: Address Line 2:
City: State: Zip:*