Organization/Dance School Name*

Choreographer Name*

Contact Name*

Contact email Address*

Contact Phone Number*

Type of Performance*

Classical DanceSemi-Classical DanceFolk DanceFilm DanceOther

Number of Performers*

Age Group*

Music/Song Title(s)*

Short description of your performance*

Duration of the Performance*

Names of the Performers

How many DVD Copies of your performace would you like to purchase?

You Tube Link

Are you willing to repeat the performance?*

YesNo

I hereby acknowledge that I have read and agree to the guidelines published for performing at INDIA DAY*

Please Sign Below given space with Mouse

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