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
Warren Heyes
April 15-16, 2000: Cambridge, Massachusetts

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

Saturday Workshops

Sunday Workshops

	E	Lindy Hop Intermediate/Advanced
	F	'20s Charleston
	G	Dancing Fast!
	H	Advanced Lindy Hop Routine

Partner's name for workshop H.

Cost

Cost per person:	Payment received by April 8	Payment received after April 8
Any 1 workshop	$15	$20
Any 2 workshop	$30	$40
Any 3 workshop	$40	$55
Any 4 workshop	$50	$70
Any 5 workshop	$60	$85
Any 6 workshop	$70	$100
Any 7 workshop	$80	$115
All workshops	$90	$130

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

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

Clear Form

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

International Lindy Hop Workshop Series Registration Form Warren Heyes April 15-16, 2000: Cambridge, Massachusetts