Nolte Academy of Dance Online Registration

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Welcome to the Nolte Academy, Iowa City Youth Choir, and Open Doors Dance Festival registration! Whether you're a beginner or an experienced performer, you're in the right place. Please complete the online registration form for your family. At least one electronic payment method (bank account (ACH) or credit card) must be entered. If you have any questions, please contact us at info@nolteacademy.com or 319-688-9289.

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Referral Information

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Referral Name

Family Information

Family Last Name*

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Home Address*

City*

State*

Zip*

Primary Phone*

Additional Info

Physician, Preferred Hospital*

Prefer Automatic ACH on (Y/N)*

Prefer Automatic CC (Y/N)*

Contact #1

Contact #1 First Name*

Last Name *

Type*

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Cell # *

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Contact #2

Contact #2 First Name*

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Type*

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Home Phone

Work #

Cell # *

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Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

Grade Level

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Special Needs (Leave blank if NONE)

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Student's First Name*

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Student Email

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Additional Info

Student Email

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Disabilities (Leave blank if NONE)

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Account Number

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Referral Information

Family Information

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Contact #2

How can we contact you?

Student #1

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Student #2 (Show-Hide Details)

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