STATE DANCE FESTIVAL REGISTRATION

School   Teacher

School Address

School Phone   Home Phone E-mail

My school will be performing

My school will not be performing

Institutional Member of NDEO/AzDEO?      Yes        No

DATE OF SPRING DANCE CONCERT:

VIDEO ORDERS ($20 for members, $30 for non-members):   

    Total amount owed:

    Please Check One:    Included in purchase order/check    I will pay cash at the festival

Total number of students attending (maximum 20)

Total Owed:

        Early Registration (before 1/30) for 20 (member $150, non-member $225)      

        OR

        Late Registration (after 1/30) for 20 (member $200, non-member $275)         

        Video (members $20, non-members $30)                                                       

        Adjudication - $15 per school                                                                                  

         T-Shirts Ordered (see order form)      Payment Included                          
            (may also bring t-shirt payment to festival)                                     

        Total                                                                                                              

AFTER PAYMENT HAS BEEN RECEIVED (P.O. OR CHECK) YOU WILL RECEIVE TICKETS FOR CLASSES.