APPLICATION FOR MEMBERSHIP

Name:		_______________________________	Date: ___/___/_____

Partner:		_______________________________	Phone ____-____-______

Address:	_________________________________________________________
		City, State, Zip Code

Applying as:		______ Caller		______ Cuer 

Qualifications:
1.	Have you ever belonged to the Capitol Callers & Cuer’s Assocation before: _____

If yes, When? _____     If yes, you do not need to fill out application any further.

2.	Number of years dancing:		Square ______		Round _____

3.	Number of years experience:	Calling ______		Cueing _____

4.	Number of years as a club -		Caller	______		Cuer    ______

List clubs and locations (city, state): _____________________________

___________________________________________________________

List referances (List names, and addresses of callers or cuers who will vouch for you calling or cueing ability). 

___________________________________________________________________

5.	Number of square or round dance courses taught:

Level ________	Quantity _____	Where ____________________ 

Level ________	Quantity _____	Where ____________________ 

6.	Have you attended a caller or cuer’s class?  ______

Where? ___________________________________________________

7.	List any pertenant information concerning your calling, cueing and teaching ability:

_____________________________________________________________ 

_____________________________________________________________ 

SPONSORED BY

I, __________________________ recommend __________________________ for membership in the Capitol Caller’s and Cuer’s Association. (Note: Sponsorship does not guarantee acceptance.)