Contact Information
Please provide us with your group representative's first and last name as on their government issued photo ID for sign-in purposes.

First name:

Your legal given name as on government issued ID

Last name:

Your surname as on government issued ID

Preferred name:

How would you like to be addressed?


A valid email address so we can contact you


Your preferred phone number

Group Information
Group Name:

Your group name or title

Anime series:

Anime series

Number in group:

How many group members do you have?


List group members:
Please provide a list of full legal names of all members in your group including your representative. Required

Performance Songs (Three songs maximum, for a maximum 15 minutes full performance):
Please list the songs you intend to use here, up to a maximum of three songs, 15 minutes performance duration in total. Required

Associated dance groups:

Are any of your group members participating with other dance groups?

Yes No
Additional Information
Previously submitted:

Did you previously submit a dance panel for Animethon 24 using the Panels Form?

Yes No

Closing participation:

Will your group participate in closing tribute at end of the dance showcase?

Yes No

Additional Information:
Anything else you'd like to add to assist us in our assesment of your submission?
Signature of group representative
By checking this box, you agree to abide by all Animethon policies polices and have read, understood and agree to abide by the Panel Submission Guidelines and Rules.

Once your submission is received, a confirmation email will be sent to the email provided above. Please review to ensure all information provided is correct.

If you need to correct any information on this form, email Do not resubmit this form. Thank you.


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Date: 2017-11-21

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