NORTHWEST DANCE NETWORK

2442 N.W. Market Street, #168
Seattle, WA 98107
(206)781-1238

SECURE REGISTRATION FORM

Fields with an asterisk* are mandatory

Please choose the appropriate option:* First-time student Returning student (have taken classes in the last six months) Returning student (have not taken a class in the last six months)
Dancer 1*			Dancer 2
Address*			Address
City*			City
State*			State
Zip*			Zip
Home Phone*			Home Phone
Work Phone*			Work Phone
Email Address*			Email Address
*	Lead Follow		Lead Follow

I'm registering because I heard about Northwest Dance Network through: (please check the appropriate box)
	a friend		an ad in
	another dance organization		an NDN newsletter
	an NDN flyer		a mailing I received

If you are repeating Swing 1, Salsa 1 or Waltz 1 (for 1/2 price), please check the box for BOTH the class (e.g., Swing 1 (Sun)) AND the repeat (e.g., 1/2 price (repeat)).

JUNE 2008 CLASSES • $45 per class (4-week classes) Name of Class (day of class ) • time of class • date class begins
Cha Cha Cha-BOOM! (Sun) • 4:00 - 4:55 • 6/1	Swing 1 (Thurs) • 6:30 - 7:25 • 6/5
Night Club 2-step (Wed) • 8:40 - 9:35 • 6/4	Swing 2: Summer Shines! (Thurs) • 7:35 - 8:30 • 6/5
Salsa 1 (Sun) • 6:10 - 7:05 • 6/1	Swing Survivor ($110) (Tues) • 6:30 - 9:00 • 6/3 • Mt. Baker CC
Salsa 2: Tie the Knot! (Sun) • 7:15 - 8:10 • 6/1	Waltz 2: Role Reversal (Thurs) • 8:40 - 9:35 • 6/5
Salsa 3: Advanced (Sun) • 8:20 - 9:15 • 6/1	West Coast Swing 1 (Wed) • 6:30 - 7:25 • 6/4
Swing 1 (Sun) • 5:05 - 6:00 • 6/1	West Coast Swing 2 (Wed) • 7:35 - 8:30 • 6/4
	1/2 price (repeat)

JULY 2008 CLASSES • $45 per class (4-week classes) Name of Class (day of class ) • time of class • date class begins
Salsa 1 (Sun) • 6:10 - 7:05 • 7/13	Swing 2: Role Reversal (Thurs) • 8:40 - 9:35 • 7/10
Salsa 2: Flips, Fans & Fakes (Sun) • 7:15 - 8:10 • 7/13	Waltz 1 (Thurs) • 6:30 - 7:25 • 7/10
Salsa 3: Advanced (Sun) • 8:20 - 9:15 • 7/13	Waltz 2: Toward Turning Bliss (Thurs) •7:35 - 8:30 • 7/10
Swing 2 x 4 ($90) (Sun) • 4:00 - 6:00 • 7/13
	1/2 price (repeat)

SPECIAL WORKSHOPS and DANCES
Check box to register for workshop or dance...
WC Swing / Night Club 2-step: Deux • $45 • (5/18/08) •Patti Conley & Marc Imlay • Swedish Cultural Center
Dance Sensation 2008 • $100 deposit • (10/23-26/08) • a whole slew of great instructors • Seabeck
CONTRIBUTION • 501(c)(3) nonprofit • tax deductible (enter amount in "Comments & Suggestions" below)

Check box to purchase Class Discount Card
10-Class Discount Card • $550

PAYMENT OPTIONS
CREDIT CARD (MC or Visa Only)	CLASS DISCOUNT CARD
Cardholder Name Credit Card Number Credit Card Expiration	Cardholder Name Class Discount Card #

Comments & Suggestions