Facilities - Request an Instructor or Class

Name of Club: 

Street Address:          City:         

State:          Zip:        Phone:  ()        

Contact Name:  

Contact Email: 

What are you looking for (please check all that apply)?

Zumba® Basic   Zumba® Gold    Substitute Instructors

Zumba® Instructor for Class (if you check this, please fill out info below)

      Class Day:    Class Time:    AM or PM

Additional Comments:

 

We are interested in hosting a Special Event Master Class

We are interested in hosting a Zumba® Basic or Zumba® Gold Workshop

Clicking 'Submit' will send your request to the Instructors in the Zumba-Illinois Network -
clicking 'Reset' will clear the form.