The Pink Jukebox Trophy 2021 Entry Application

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Names *

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Preferred Method of Contact

Please be sure to provide contact details that correspond with your preferred method of contact.  It is not necessary to provide other types of contact details. *

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Email Information

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Telephone Information

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Mailing Information

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Special Needs

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Intended Competition Categories *

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Level for each category entered (Introductory, Intermediate or Advanced)
eg Solo Ballroom Introductory *

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Privacy consent
I understand that by submitting the films, I give permission to use excerpts for promotional purposes; and to broadcast them during the prize-giving event via Zoom.
*

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Country or countries represented
Please identify the country or countries that you are representing

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