MEMBERSHIP FORM

Memberships are annual with dues paid each January.

Please print and mail to address at bottom.

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 Dance Alliance and mail to:

Partners in Dance
Attn: Debbie Nichols
c/o Skidmore College Dance Department
Saratoga Springs, NY 12866