Studio Private Lesson Request

First/Last Name *

First

Last

Phone number *

Email *

Are you: *

Is this for: *

Are you interested in:

How long have you been pole dancing? *

Describe the types of classes you've enjoyed in the past. *

Please specify whether you've attended/enjoyed classes here at Rocknasium or elsewhere.

What are you hoping to gain from private instruction? Do you have an specific goals? *

What style best describes your goals? *

Examples: contemporary, flowy/fluidity, athletic/strength, dynamic, sensual, sexy, etc.

What days/times do you have available? *

Is there anything else we should know? *

Do you have a teacher preference? *