Name eg: Alex SmithUse separate submission for each person. Email Address eg: asmith@aol.comIf you do not have email be sure to provide a telephone number below. Telephone (day) eg: 508–555–1234x56 (evening) eg: 508–555–1234 (cell/mobile) eg: 508–555–1234 Friday Newton Workshops November 26, 2010 Rhythm (7:30–8:30pm) Slower Routine (8:40–9:40pm) Saturday Brookline Workshops November 27, 2010 Solo Jazz Routine (3:00–4:00pm) Lead & Follow (4:10–5:10pm) Lindy Hop Partner Routine (5:20–6:20pm) Partner's name for Lindy Hop Partner Routine workshop. Uptown Swing Dance with the Gordon Webster Band (8:15pm–12:30am) (discount available with student ID) Sunday Newton Workshops November 28, 2010 Lindy Hop Fundamentals (1:00–2:00pm) Building On Your Basics (2:15–3:15pm) Footwork (3:30–4:30pm) Partnering (4:45–5:45pm) Cost per person Discounts are for the same person taking multiple workshops. Number of Workshops Early BirdPayment byOctober 27, 2010 DiscountPayment byNovember 17, 2010 FullPayment afterNovember 17, 2010 Any single workshop $15 $19 $23 Any 2 workshops $30 $38 $46 Any 3 workshop $45 $57 $69 Any 4 workshop $55 $70 $85 Any 5 workshop $65 $83 $101 Any 6 workshop $75 $96 $117 Any 7 workshop $85 $109 $133 Any 8 workshop $95 $122 $149 All 9 workshops $105 $135 $165 All 9 workshops & Uptown Swing Dance $115 $145 $175 Uptown Swing Dance +$15(+$10 with student ID) Total Amount $ Role Not Sure What This Means Lead Follow Where you heard of us Status New If you are not already on our mailing list complete the following fields. Already On Mailing List If your address is already on our mailing list skip the following fields. Change Of Address If your address has changed complete the following fields. Same Address As If same address as another person already registered, just note their name in the Comments section below and skip the following fields. Extra line for address, leave blank if not needed. Street Town State eg MA ZIP Comments Verification Code 9421 Please enter the verification code as it is shown above: Used to help prevent SPAM-Bot submissions. Submit Registration Information