NDW DELEGATE REGISTRATION

DELEGATE REGISTRATION FORM

Notice to all McAfee Site Advisor/Vista users:
Be aware that all those who register with NDW as Delegates or as Kickline supporters, your name and/or contact data (with appropriate links) is placed on the NDW website UNLESS you indicate to the NDW office that you do NOT want this infomation listed. An alert occurs for the McAfee/Vista users which shows a complaint that the NDW website places registrations contact data on the website allowing for spammers to access the data. While the data is listed, all parties are given the option to NOT have such information listed. You may make this request by sending an email to:director@nationaldanceweek.org and your choice will be honored within 24 hours or less.

Registrations now being accepted for National
Dance Week 2009

Print this form out, complete, and mail to: Patricia Goulding, NDW Executive Director, 142 Parkedge Rd, Pittsburgh, PA 15220, OR Fill out the online form below & press "Submit"

Leave no blank spaces; if no information is available or preference is to be not listed, enter "NA". Blank spaces will cause form to not process correctly.
Thank you

Yes, I would like to sign on as a new ______ returning ______ delegate for National Dance Week to serve in the capacity of:

______Regional Director ______Professional Representative.

I am a _______Studio Owner/Director/Teacher ______Retail Store Owner ______Professional working in alternate setting ______Friend of the Art of Dance

_____ I will make a contribution of $25.00 to NDW.

NAME ______________________________ PHONE_______________________

ADDRESS _____________________________________

CITY/STATE/ZIP _________________________________________

EMAIL____________________________________

Print this form out, complete, and mail to: Patricia Goulding, NDW Executive Director, 142 Parkedge Rd, Pittsburgh, PA 15220 OR Fill out the online form below & press "Submit"

Leave no blank spaces; if no information is available or preference is to be not listed, enter "NA". Blank spaces will cause form to not process correctly.
Thank you

Mail completed form to above address.

Click here to make your donation, or mail donation to: NDW, c/o UDMA, 376 MAIN ROAD, GRANVILLE, MA 01034

Yes, I would like to sign on as a
new delegate
returning delegate
(check new or returning) for National Dance Week to serve in the capacity of:

Regional Director
Professional Representative

I am a: Studio Owner/Director/Teacher Retail Store Owner
Professional working in alternate setting Friend of the Art of Dance

Your name

Your phone

Your address

Your City/State

Your zip code

Your email

APRIL 24 - MAY 3, 2009
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