Ordering Process

Please fill out the form below. Our staff will contact you via email and/or phone once your account is ready. Use this form to setup a 15 day trial. Payment will NOT be required until your trial ends.

e-Ballroom.com will only use the information collected to establish a customer profile. Your information will not be distributed outside of e-Ballroom.com. By providing your information below, you authorize e-Ballroom.com to contact you via phone, written correspondance, and/or email.

Single Studio Options

Customer Information

* indicates a field is required.
*First Name:
*Last Name:
*Email Address:
*Confirm Email Address:
*Dance Studio Name:
*Studio Phone Number:
Studio Website:
*Studio Address:
                    How did you hear about us? 
Human Verification



Please wait while we provision your account. This may take a minute. If you are prompted to correct or add information, you can close this dialog and resubmit.

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