questionnaire - Yuva Bharati
questionnaire - Yuva Bharati
questionnaire - Yuva Bharati
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Application for <strong>Yuva</strong> <strong>Bharati</strong> Solo Performance<br />
Name of the Performer : __________________________________________________<br />
Address : ______________________________________________________________<br />
Email :_________________________ Phone : _______________________________<br />
Dance Form : ____________________________<br />
List Years of Training in Classical Dance:<br />
Dance Teacher : _________________________________________________________<br />
Dance School : __________________________________________________________<br />
Start Date & End Date: ___________________________________________________<br />
Dance Teacher : _________________________________________________________<br />
Dance School : __________________________________________________________<br />
Start Date & End Date: ___________________________________________________<br />
Dance Teacher : _________________________________________________________<br />
Dance School : __________________________________________________________<br />
Start Date & End Date: ___________________________________________________<br />
Solo Debut Date & Location : _______________________________________________<br />
Awards or Honors Received : _______________________________________________<br />
_______________________________________________________________________<br />
Notable Performances & Productions: _________________________________________<br />
________________________________________________________________________<br />
Academic Achievement : __________________________________________________<br />
________________________________________________________________________<br />
If employed, employer :____________________________________________________<br />
Any other classical dance related activities :____________________________________<br />
_______________________________________________________________________<br />
_______________________________________________________________________<br />
Cisco Systems, Inc. Page 1 11/12/2010 1
Sponsorship for 1 hour segment is $500. We encourage local student performers to find<br />
sponsors as support for <strong>Yuva</strong> <strong>Bharati</strong>. Please answer the following questions regarding<br />
sponsorship after careful consideration. If you agree to sponsor or find a sponsor we<br />
expect the candidate to keep the commitment.<br />
I will sponsor my segment: Yes/No<br />
I will find a sponsor for my segment : Yes/No<br />
I will perform only if <strong>Yuva</strong> <strong>Bharati</strong> finds a sponsor: Yes/No<br />
<strong>Yuva</strong> <strong>Bharati</strong> would like to Video tape the event for the organization record. The<br />
recordings will not be used for any commercial purpose. Please answer the following<br />
questions regarding videography.<br />
I will allow <strong>Yuva</strong> <strong>Bharati</strong> to video tape my event : Yes/No<br />
I request <strong>Yuva</strong> <strong>Bharati</strong> to provide me a copy of the video tape : Yes/No/NA<br />
I will allow <strong>Yuva</strong> <strong>Bharati</strong> to video tape specific item identified by me : Yes/No<br />
I would like to video tape my segment of the program : Yes/No<br />
Have you attended <strong>Yuva</strong> <strong>Bharati</strong> Events : Yes/No<br />
Approximately how many <strong>Yuva</strong> <strong>Bharati</strong> events did you attend :<br />
Did you volunteer for any <strong>Yuva</strong> <strong>Bharati</strong> Events : Yes/No<br />
How many <strong>Yuva</strong> <strong>Bharati</strong> events did you volunteer :<br />
Please email the following ( do not send paper copies)<br />
• filled-in copy of this document.<br />
• Digital pictures in classical dance dress.<br />
• Video clipping of recent classical dance item performed by you. ( 5 to10 mins<br />
solo performance)<br />
to yuva_bharati@yahoo.com.<br />
.<br />
Online video is preferred. But DVD/VHS is acceptable if online video is not<br />
available. Any audio/video material submitted cannot be returned so please do not<br />
submit the master copy.<br />
Cisco Systems, Inc. Page 2 11/12/2010 2
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