Reservation Form

Name(s):___________________________________________________________________

Address: __________________________________________________________________

___________________________________________________________________________

Phone: __________________  e-mail address: ________________________________

Dance instructions? _________ (Also available on this web site.)

Hospitality:  Yes ____  No ____  Allergies? _______________________________

Hotel/Motel Information? Call Ames Convention and Visitors Bureau,
 1-800-288-7450 
 
Others in Party? __________________________________________________________

Dinner will be a full buffet with meat and vegetarian choices and salad bar. 

                                   Number of tickets

Cost:    Ball/Dinner        ($45)      _______ 
                  
         Dinner (nondancer) ($30)      _______

         Dance only         ($25)      _______

         Friday Night Concert ($12)*   _______    Total cost  ________

  Postmarked after May 1 - add $5 late fee to each registration.** 
      
Will you be attending the music workshop? Yes_____ No_____

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 or for mailed dance instructions.

   * Students: $10; at-the-door cost: $15
  ** ISU requires us to have a guest count by May 1, therefore we must
     charge the extra $5 late fee for any registration after that date.