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Jeff Booth & Marina Glezin Workshop Home Page | Schedule | Location | Registration | Registration Form | Hop to the Beat Swing Jam | Directions to Cambridge Friends School, MA

This workshop has already happened!
(check International Workshop Series page for upcoming workshops)

International Lindy Hop Workshop Series Registration Form
Jeff Booth & Marina Glezin
October 13, 2001: Cambridge, Massachusetts

Step 1: Submit Registration Information
Please complete and submit the following form which provides your registration information and classes you wish to take. Use a separate form for each person. A registration is not complete and a place is not secured until payment is also received. It is still helpful, and will speed your check-in, to submit a form even if you will be paying at the first class. If you change your contact information (email/telephone/etc.) after registering, please use our on-line mailing list form to notify us of the updates or contact us directly with the information.
 
Step 2: Make Payment

International Lindy Hop Workshop Series Registration Form
Jeff Booth & Marina Glezin
October 13, 2001
Name
(use separate submission for each person)
Email Address
(if you do not have email be sure to provide a phone number below)
Telephone (day)
eg: 508-555-1234x56
(evening)
eg: 508-555-1234
(cell/mobile)
eg: 508-555-1234
Workshops
Saturday, October 13, 2001:
Cambridge, MA
Dean Collins Shim Sham (Part 1)
Lindy Hop 1
Lindy Hop 2
Dean Collins Shim Sham (Part 2)
Cost per person:
  Payment
received by
Oct 9
  Payment
received after
Oct 9
Any 1 workshop   $15   $20
Any 2 workshops   $30   $40
Any 3 workshops   $40   $55
All 4 workshops   $50   $70
Total Amount being Sent
$
Status
New
If you are not already on our mailing list complete this section.
Already On Mailing List
If your full address is already on our mailing list skip this section.
Change Of Address
If your address has changed complete this section.
Same Address As
If same address as another person already registered, just note their name in the Comments section below and skip this section.
 
(extra line for address, leave blank if not needed)
Street
Town
State ZIP
Where you heard of us
Role
Not Sure What This Means
Lead
Follow
Comments
Verification Code 2194
Please enter the verification code as it is shown above (used to help prevent SPAM submissions).
Submit Registration Information Submit Form Disabled

This workshop has already happened!
(check International Workshop Series page for upcoming workshops)

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