Registration Form

Name(s):___________________________________________________________________

Address: __________________________________________________________________ 

___________________________________________________________________________

Phone: _____________________ e-mail address: ______________________________

Hospitality:  Yes _____  No _____  Allergies? _____________________________

Hotel/Motel Information? _______  Others in Party? ________________________

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

Cost: Ball/Dinner - RSCDS member - ($35/$40)* 
                  - Non-member   - ($40/$45)* 
      Dinner only (includes 3 dances) - ($25/$30)*
      Dance only - $20
      Spectator only (no dinner) - $10
      Students - 10% discount                        

Will you be attending the music workshop? Yes_____ No_____
Music workshop is co-sponsored by the Ames Commission on the Arts and
the RSCDS, Central Iowa Branch.

*ISU requires us to have a guest count by May 2. Therefore, we must 
charge the higher amount for any registration after that date.

Please make checks payable to "RSCDS Central Iowa Branch" and return to 
Gayle Hoepner, 413 10th Street, Ames, IA 50010.

Please include self-addressed stamped envelope for return confirmation.