Reservation Form

Name(s) of each attending: ________________________________________________

___________________________________________________________________________

Address: __________________________________________________________________ 

Phone: _____________________   e-mail address: ____________________________

Copy of Dance Instructions? _____ 

Hospitality:  Yes (How many) ____   

Allergies? Smoking? Preferred Sleeping Arrangements?_______________________

___________________________________________________________________________

Hotel/Motel Information? _______  Others in Party? ________________________

Food preference for ball dinner (Buffet Style): Chicken ___  Vegetarian ___ 

Number of                   RSCDS       
People                      Member     Non-member      Amount
		
_____  Dinner and Dancing    $35          $40         ________  
     
          ( after May 1*)    $40          $45         ________  
 
_____  Dancing only          $20          $25         ________  

          ( after May 1*)    $20          $30         ________  

_____  Dinner and spectator  $20          $25         ________

          ( after May 1*)    $25          $30         ________        

_____  Fri. Concert Tickets  $10          $10         ________ 

             ( students )     $7           $7         ________
      
                                         Total amount ________

Will you be attending the music workshop? (Sat. 10-12)? Yes_____ No_____
Music workshop is co-sponsored by the Ames Commission on the Arts.
We have funding so this event is free!

*ISU requires us to have a guest count by May 1.  Therefore, we must
 charge the higher amount for any registration after that date.

Please make checks payable to "RSCDS Central Iowa" and return to 
Gayle Hoepner, Treasurer, 413 10th Street,  Ames, Iowa 50010 by May 1.
Include SASE for return confirmation or dance instructions.