THE ROYAL SCOTTISH COUNTRY DANCE SOCIETY
BERKS/HANTS/SURREY BORDER BRANCH
SCD TEACHERS DATABASE DATA COLLECTION FORM
Charity No. 1067776
1
Personal details:
Title
Given Name(s)
Family Name
Address
Post Code
Telephone No
Mobile No
Email
Qualifications:
Certificate held
Date acquired
Interests – please describe the types of class you have taken and are interested in taking
One off guest classes
Day schools
Beginners classes
Intermediate classes
Advanced classes
Mixed ability groups
Social dancing groups
Children’s classes
Demonstration teams
Calling at social
events
THE ROYAL SCOTTISH COUNTRY DANCE SOCIETY
BERKS/HANTS/SURREY BORDER BRANCH
SCD TEACHERS DATABASE DATA COLLECTION FORM
Charity No. 1067776
2
Other relevant
information
Other information
How far are you
willing to travel
for a one off class/event?
for a regular class?
If there is no live
music do you have
your own sound
equipment?
Do you have your own
CDs or computer
based music?
Please add any other information that you think will help to match you with “customers”
Please return completed form by email to
dbarnet@waitrose.com
or by post to:
Duncan Barnet
Flat 4
8 Western Elms Avenue
Reading RG30 2AN