Vancouver ECD Ball
			      Saturday, April 17th, 2010
                                  Registration Form
                                (please print clearly)


Name(s) ____________________________________________________________________________

Address(es) ________________________________________________________________________

Evening phone(s) _______________    email(s) _______________________________________


I'm registering _____  @ $50 Cdn/U.S. funds

I'm requesting a full/partial scholarship of $ ______

Total amount enclosed $_____________


Billeting: If you are a local dancer, consider hosting some visitors from out of town

I can provide housing for ____ people.  I have household pets: yes ___, no ___.

I need housing for ___ people on Fri. night ___, Sat. night ___.  Pets are: okay ___, not okay ___.

I plan to attend the Sunday brunch ___.

Put my contact info on the ball participants list: yes ___, no ___

I'd love to volunteer to help with the ball _______


Please enclose full payment and make cheques payable to "Michael Dyck"
Send registration to ECD Ball, 2490 West 49th Avenue, Vancouver, BC, V6M 2V3