Dancing For The Survivors
Dancer Application

Thank you for your interest in dancing at Pink Fund’s signature fundraising event, Dancing For The Survivors. The event will be held on Friday, October 3rd 2025 from 6:00 – 11:00 p.m. at the Mint. The evening will include cocktails, dinner, and dancing. It will feature ballroom dances performed by local breast cancer survivors partnered with professional dancers from Fred Astaire Dance Studios. All dancers will receive complimentary dance lessons to prepare for their performance.

Name(Required)

First Last

Email(Required)

Phone(Required)

Address(Required)

Street Address City State ZIP / Postal Code

Age(Required)

Your Network

Instagram

Facedbook

Name of Organization / Company (if applicable)

Title/Position

Please list your social and business networks. How would you engage these networks to fundraise for Pink Fund's mission?(Required)

Your Breast Cancer Diagnosis

Year you were diagnosed(Required)

Please enter a number greater than or equal to 1000.

Stage/Grade(Required)

Where did you receive treatment?(Required)

How did you feel when you heard the news of your diagnosis?(Required)

How did your breast cancer diagnosis impact your finances?(Required)

What motivates you to support the mission of Pink Fund?(Required)

Additional information you would like us to know about you (i.e. marital status, children, profession, hobbies, charitable works, etc.)

Dancing For The Survivors
Dancer Application

Your Network

Your Breast Cancer Diagnosis

CONTACT PINK FUND

CONNECT WITH US

Dancing For The Survivors Dancer Application

Your Network

Your Breast Cancer Diagnosis

Dancing For The Survivors
Dancer Application