"Bollywood Shake" Mar / Apr / May 2010 Classes Registration Survey

"Bollywood Shake" Mar / Apr / May 2010 Classes Registration

1. "Bollywood Shake" Dance Class Registration Form

Please enter the information below to register for any of our sessions starting in March / April / May 2010

No prior Bollywood dance experience required. Comfortable attire.

Payment can be made on the first day of class or by credit card at our website.

Check out further details on our website at http://www.bollywoodshake.com. For additional questions, e-mail info@bollywoodshake.com or call 512-432-5716.

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Note: The following classes are FULL -

1. March Central class (Mondays 8-9pm)
2. March North 6pm class (We opened a new class for 5pm, so that is still open)

"Bollywood Shake" Mar / Apr / May 2010 Classes Registration

1. "Bollywood Shake" Dance Class Registration Form

*
1. Full Name:

*
2. Contact Phone Number:

*
3. E-mail address:

4. Address:

*
5. I choose to register for the "Bollywood Shake" dance classes at the following location:

*
6. I would like to sign-up for the following session:

7. Age (required for children's classes):

8. Dance skill level:

*
9. What would you like to get most out these classes?

10. Comments/Suggestions/Requests? (Groupon customers please mention your Groupon code here)

"Bollywood Shake" Mar / Apr / May 2010 Classes Registration

1. "Bollywood Shake" Dance Class Registration Form

*1. Full Name:

*2. Contact Phone Number:

*3. E-mail address:

4. Address:

*5. I choose to register for the "Bollywood Shake" dance classes at the following location:

*6. I would like to sign-up for the following session:

7. Age (required for children's classes):

8. Dance skill level:

*9. What would you like to get most out these classes?

10. Comments/Suggestions/Requests? (Groupon customers please mention your Groupon code here)

*
1. Full Name:

*
2. Contact Phone Number:

*
3. E-mail address:

*
5. I choose to register for the "Bollywood Shake" dance classes at the following location:

*
6. I would like to sign-up for the following session:

*
9. What would you like to get most out these classes?