TDI  Judiciary Membership Application 2008-2009
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Name*:

Email Address*:

Street Address*:

City*:

State*:

ZIP*:

Date of Birth (DD/MM/YYYY):*

Home Phone*:

Cell Phone*:

Work Phone*:

What is the best way to reach you (via cell/home/email,etc)? *

TDI Judiciary Member Since*: 


















Years Experience Judging*:

Current profession*:


What organizations do you have personal experience competing or judging within?* (click all that apply):

Nametags are re-issued every three (3) years and are updated yearly with stickers that are affixed to the nametag.  Replacement tags are $10 each.  

If you are an existing member in need of a replacement nametag this year please
mark the box below 


TDI never sells it’s membership lists to outside vendors.  However, if you do NOT wish your email address to be shared with other dance-associated groups/vendors outside of TDI, please check here: 



Other (Please List)
Conflict of Interest Disclosure Statement:* (choose one)


I have never personally been a team member, parent of a team member, coach, choreographer, teacher, or employer of a spirit based team in Illinois within the past 3 years

I  HAVE personally been a team member, parent of a team member, coach, choreographer, teacher, or employer of a spirit based team in Illinois within the past 3 years and I have disclosed them below:

Name of SchoolRole (Coach, Choreographer, Member,Parent, etc)               Years Affiliated
Note:  Failure to disclose a potential conflict of interest could result in suspension of judging privileges and/or membership in TDI Judiciary Association.
Yes, I need a replacement name tag.
Yes, you may share my email address.
No, Do not share my email address.
TDI
UDA
NDA
IDTA
Halftime Illinois
WGI
Showstoppers
Worlds
ICCA
None