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DANCE ALLIANCE
APPLICATION FORM FOR MEMBERSHIP
Any questions? Call 401-295-7025
or email dn@riDance.com
1 year membership - $30.00
2 Years - $55.00
3 years - $75.00

Date of membership ____________
(above is for DA process, do not fill in)

Print and fill out Application
One form per person
Mail Application and check to:
Dance Alliance
PO Box 372
East Greenwich 02818
NAME: _________________________________________

CONTACT PHONE: _________________________

EMAIL:_____________________________

MAILING ADDRESS:
Street wt number or PO: ____________________________________________________

City: ________________________ State: ______________ Zip: ___________


SCHOOL/STUDIO/ORGANIZATION AFFILIATION (if any)
___________________________________________

AREA OF INTEREST: ________________________________________


1 year membership - $30.00
2 Years - $55.00
3 years - $75.00
_________________
_________________
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Optional donation to scholarship fund_________________
Total enclosed
(Make check out to Dance Alliance)
_________________