October 7, 2006 REGISTRATION | |
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Directions & Confirmation will be sent upon receipt of payment Any questions? Phone 401-521-0546 Email doug.dance@juno.com |
Print out this form and mail with check (made out to Doug Victor) to: Doug Victor 103 Princeton Avenue Providence, RI 02907 |
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NAME: _________________________________________ PHONE: ________________________________________ EMAIL:_____________________________ MAILING ADDRESS: Street wt number or PO: ____________________________________________________ City: ________________________ State: ______________ Zip: ___________ Creative Dance Tuition...$50.00 Enclosed is my non-refundable deposit ($25.00) ________ Or Enclosed is the full tuition (enter amount) ________ Balance due (enter amount) ________ | |