52 High Street, Waipawa
Postal address: Grishko NZ Ltd, 108 Racecourse Road, RD2, Otane, 4277
Place of fitting: Date of fitting:
Assessed and fitted by:
Please would you fill in below and email or post this back to us.
We will then contact you for an appointment. Many thanks!
Would you like a ____ Full Assessment and a fitting $120.00
____ Half Assessment and a fitting $90.00
Dancers First Name: Surname:
Telephone Number: Mob. No.
Date of Birth Age now:
Name of Ballet school:
Name of Teacher:
Permission to pass on report to your teacher? YES/NO
What Grade do you study?
How many ballet classes a week do you attend?
How long are they?
Your current school shoe size?
If already on pointe when did you start?
How tall are you? Are you still growing?
Have you had a growth spurt? If yes, when was it?
At school, are you tall or small in your class?
Have you started your period? If yes, when did it start?
What to bring to a fitting:
Clean feet, cut toenails, convertible ballet tights, leotard, current pointe shoes if you are already
Cheque or cash