RD

2121 BROADWAY, 3 FLOOR

NEW YORK, NY 10023
212-874-2410 www.stepsnyc.com

WORK/STUDY INTERVIEW APPLICATION

DIRECTIONS: COMPLETE BOTH SIDES AS THOROUGHLY AND ACCURATELY AS POSSIBLE. PLEASE PRINT!

Interview Date: ______________________

FIRST NAME: _________________________________ LAST NAME: __________________________________________

LOCAL ADDRESS: ____________________________________________________________________________________

APT. # __________ CITY: _______________________ STATE: ___________ ZIP CODE: ___________________________

PERMANENT ADDRESS: _______________________________________________________________________________

APT. # __________ CITY: _______________________ STATE: ___________ ZIP CODE: ___________________________

HOME PHONE ( _______ ) ______________________ DATE OF BIRTH: ___________________ SEX: _______________

SERVICE/CELL ( _______ ) ______________________ EMAIL ADDRESS: _______________________________________

COMPLETE ALL APPLICABLE INFORMATION:

Are you fluent in a language other than English? ____ Yes ____ No (Please Check One)

If yes, please list language(s): ______________________ ______________________ ______________________

DO YOU PERMANENTLY RESIDE IN THE NEW YORK CITY AREA ? ________

If YES, for how long ? __________________ If NO, how long do you plan to be in New York ? ___________________
Are you available immediately ? _________ Are you available for a minimum of twelve (12) weeks? __________

IMPORTANT: If accepted, you must be available to begin a Work/Study position immediately. If you are not available to begin
immediately, your application will not be considered at this time.

DO YOU HAVE ANY COMMITMENTS (i.e. a job, school, etc.) THAT MAY INFLUENCE YOUR AVAILABILITY? ________
If yes, explain: ________________________________________________________________________________________

EDUCATION
NAME OF INSTITUTION DATES GRADUATED COURSE OF DEGREE
STUDY

HIGH SCHOOL : FROM: TO: yes / no

COLLEGE : FROM: TO: yes / no

GRAD SCHOOL : FROM: TO: yes / no

OTHER (DESCRIBE): FROM: TO: yes / no

AREAS OF STUDY: (LIST TEACHERS FOR ALL DISCIPLINES AND CIRCLE YOUR STRONGEST)
BALLET: ____________________________________________________________________________________

JAZZ: ____________________________________________________________________________________

TAP: ____________________________________________________________________________________

MODERN: ____________________________________________________________________________________

THEATRE: ____________________________________________________________________________________

HIP-HOP ____________________________________________________________________________________

OTHER: ____________________________________________________________________________________

WORK EXPERIENCE (OTHER THAN DANCE) Please list most recent first

POSITION WHERE PRIMARY RESPONSIBILITIES DATES

FROM:
TO:

FROM:
TO:

FROM:
TO:

FROM:
TO:

REFERENCES (LIST TWO)

NAME AFFILIATION PHONE

( )

( )

Work/Study positions are awarded based on an evaluation and potential. Attitude and work experience are strongly
considered. People accepted into the Program must complete 8-10 hours of training, a short personal interview with the
Director, and sign a Work/Study contract to become eligible to take unlimited discounted classes at Steps. Work/Study
opportunities include general administrative and maintenance positions.

I hereby confirm that all information on this application is accurate and complete to the best of my knowledge:

SIGNATURE: ______________________________________________ TODAY'S DATE: ____________________