Please enter you main email address

Please enter your mobile number or landline number

Your facebook link

Your website address if you have one

Do you have a profile account with the ELD main site?

Average amount of social events you run per year. Enter 0 if none.

Enter the number of years experience as a dance instructor

Do you have any dance instructor qualifications?

Please upload proof of qualifications if you have any, this can be forwarded later on if preferred

Date you would like the public liabilty insurance to start from. Insurance will not start until the application has been processed and confirmation sent.

Do you required a PPL music license? Please tick if required. (you will be contacted by one of the team for further information)

What is your main role in the line dance industry?

Please type any other information you would like to add. or leave blank.