Immerse Yourself In Movement!

New York City Summer Dance Intensive - July 14-20 2008

Name:

Address:

City, State, Zip Code:

Preferred Phone:

Email:

Background: (circle all that apply)

dancer  –  choreographer  –  actor  –  director  - movement lover

Need help locating affordable accommodation:

 Yes  ____   No____

Amount Enclosed:

$450 by June 30th_______________

 $500 after July 1_____________

Please make checks payable to Dance Entropy Inc.

Print out this form and return it with check to:

Valerie Green/Dance Entropy

37-24 24th St. Suite 301

Long Island City, NY 11101

Or

Simplify with our PayPal account