Registration Form: Nineteenth Annual Iowa Ball, May 1, 2010Name(s):__________________________________________________________________
Address: __________________________________________________________________
City: ________________________________ State:________________ Zip:___________
Phone: __________________ e-mail address: ___________________________________
Hospitality: Yes ____ No ____ Offer? ________________________
| Payment Options | Cost | Number of Persons | Total Cost | ||
| Ball and dinner | $55 | ______ | ______ | ||
| Ball only | $35 | ______ | ______ | ||
| Dinner only | $30 | ______ | ______ | ||
| Late fee (postmarked after | April 20) | $5 | ______ | ______ | |
| $5 discount for students | −$5 | ______ | ______ | ||
| Friday Night Concert * | Adults | $12 | ______ | ______ | |
| Students | $9 | ______ | ______ | ||
| Total | _______ |
* Cost for concert is $15 at the door.
Please be a Ball Sponsor to keep registration fees down and quality up. **
| Royal $100; Gold $50; Silver $25; | _______ |
| Total amount enclosed | $ _______ |
** RSCDS Central Iowa Branch is a non-profit charitable organization, and as such, donations are tax-deductable. We will provide you with a receipt for tax purposes.
Please make checks payable to "RSCDS-CI" and return to Gayle Hoepner, 413 10th Street, Ames, IA 50010.