Professional Membership and Examination FormFirst Name *Last Name *Applying for Individual or Couple Membership? *Individual Membership – $50.00 + $75 — $125Couple Membership – $75.00 + $75 — $150First time membership ($50 each year) + Test ($75 one time fee)Other Names Used Professionally (if applicable) – for you & for Spouse/Partner (if applying for Couple Membership)0 / 180Insert Partner's Full Name *0 / 180Email Address *Phone *Street Address *Apartment, suite, etcCity *State/Province *ZIP / Postal Code *How did you hear about NDTA? *MemberFacebookGoogleOtherMember's NameHow long have you been a dance teacher? *0-3 years4-9 years10-25 yearsOver 25 yearsTrainer's NameExaminer's namePlease Pick A Style Below *American Smooth AssociateAmerican Rhythm AssociateAmerican Smooth LicentiateAmerican Rhythm LicentiateInternational Ballroom AssociateInternational Ballroom LicentiateInternational Latin AssociateInternational Latin LicentiateWhat Information Would You Like Listed in our Public Members Directory? Please check the boxes below beside each of the items of information you submitted above that you would like included in our Members Directory (visible to all members), assuming your application for membership is approved. These enhanced Directory Listings are FREE for NDTA Members! A great way to advertise your services and potentially attract new students! Note: You will have an opportunity to update your Directory Listing at any time, after you are accepted as a Member.Your Studio or Business NameYour E-mail AddressYour Website Address(es)Your Business TelephoneYour Professional CertificationsYour Biographical InformationYour PictureYour MembershipOath * Representation & Oath: I hereby swear and affirm that the statements made in this application and in the documents attached are true and correct. I am willing to take, and I hereby take, the following NDTA Pledge: I pledge myself to uphold the constitution of the National Dance Teachers Association of America, to foster and maintain a spirit of good will toward fellow members, and to conduct my business in accordance with the Code of Ethics of the Association.Send Membership Application
