Become a student rep

For students wishing to apply for the Student Rep Program from X-POLE

Name*
First Last
Email*
Phone*
Instagram
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
How long have you been pole dancing?*
- Less than 1 year
- 1-2 years
- 3-4 years
- 5-6 years
- More than six years
Tell us about yourself. What makes you, YOU?*
What are your career goals?*
What do you like to do for fun? Describe a day in the life of _______ (you).*
In what ways will becoming an X-POLE Student Rep help you?*
How do you plan to make your adventure as an X-POLE Student Rep a fun & successful one?*
How do you plan to promote the X-POLE brand?*
What is your personal experience with X-POLE or Pole Fitness in general?*
Include any other fun facts about you*
Upload any images to support your application