Membership Level:
| Individual |
$25
|
| Organization |
$50
|
| Additional member(s) from your organization |
$10
(each)
|
|
Total Enclosed: |
I'd like to make a donation in the amount of $_________ to Partners in Dance.
Name & Title:____________________________________________________
Organization_____________________________________________________
Mailing Address__________________________________________________
_______________________________________________________________
Phone: _________________________________________________________
Fax: ___________________________________________________________
E-mail: _________________________________________________________
Website: ________________________________________________________
Make checks payable to Partners in Dance, Inc. and mail to:
Partners in Dance
PO Box 257
Saratoga Springs, NY 12866
