Former Member Information

Former CCA Member Reinstatement Application and Payment Form

This membership form is provided for former CCA member teachers who have successfully passed the Teacher Grade I Examination. The sponsor of the applicant must be a Licentiate member of the Cecchetti Council of America.

Membership Dues are $110.00 annually. There is a processing fee of $20.00 and reinstatement fee of $50.00 for all reinstated members.

WEBSITE REGISTRATION
Note: If your membership application is accepted, you'll use this username and password to login view Members Only content. **Current CCA Members must login on the "Products and Materials" page of the CCA website.
Username*
Password
Enter Password Confirm Password
APPLICANT INFORMATION
Name*
First Last
Home Phone
Cell Phone
Location*
State*
Address
Street Address Address Line 2 City ZIP Code
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Email
Date of Birth
MM/DD/YYYY
TEACHING EXPERIENCE
Certification Level*
Current Studio Name(s)
Studio Website
Years of Teaching
Studio Phone
Studio Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
TRAINING
Dance Training (include college/professional training and experience)
Indicate CCA Student exams passed
Indicate CCA Teacher exams passed*
Date of CCA teacher exam
MM/DD/YYYY
Sponsoring CCA Member*
Sponsoring CCA Teacher Name and level of CCA Certification
Additional Information
SPONSORS
Sponsoring Member*
First Last
Applicant agrees to uphold the goals and standards of the Cecchetti Council of America.*
- Agree
APPLICATION FEES
Initiation fees and dues must accompany the application.
Product Name
Membership Fees*
Yearly Dues: $110
Processing Fee: $20 (Reinstated Members Only)
- Yearly Dues:
- Processing Fee
Note: Please click the "Submit" button once, to prevent duplicate Credit Card Charges.
Reinstatement Fee*
Price: $50.00
Donate to the CCA (Optional) Specify amount of donation below
Credit Card

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Total
$0.00
Comments
This field is for validation purposes and should be left unchanged.

Former CCA Member Reinstatement Application and Payment Form

WEBSITE REGISTRATION

APPLICANT INFORMATION

TEACHING EXPERIENCE

TRAINING

SPONSORS

APPLICATION FEES

Product categories

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