Medal Test Entry Form

Full Name to be shown on Certificates *

Date of Birth *

Age on Date Of Medal Test *

Street Address *

Address Line 2

Town / City *

County *

Postal Code *

Phone *0 / 11

Email Address *

Medal Test 1

Style of Test 1 *

Grades for Exam *

Ballroom Dance 1 *

Unit Ted Badge Colour *

Ballroom Dance 2

Ballroom Dance 3

Ballroom Dance 4

Ballroom Dance 5

Latin Dance 1 *

Latin Dance 2

Latin Dance 3

Latin Dance 4

Latin Dance 5Required for Gold Bar 1 & above

Classical Dance 1 *

Classical Dance 2

Classical Dance 3

Classical Dance 4

Classical Dance 5

Modern / Latin Sequence Dance 1 *

Modern / Latin Sequence Dance 2

Modern / Latin Sequence Dance 3

Modern / Latin Sequence Dance 4

Modern / Latin Sequence Dance 5

Medal Test 2

Style of Test 2 *