AICD INTERNATIONAL BALLET AWARDS 2009

ENTRY FORM

FULL NAME:.......................................................................................

ADDRESS...........................................................................................

PHONE: H:......................................... BUS:.................................. fax / mob: ..........................................

EMAIL:...................................................................................................................................................

Date of Birth.............................. M/F (delete one) AICD Individual Member   Y / N   Membership No:............

TITLE OF CLASSICAL VARIATION:.............................................................................................................

Name of DanceSchool or Teacher: .............................................................................................................

Signature, Parent / Guardian: ..................................................................................................................

Please make cheques payable to : AICD INTERNATIONAL BALLET AWARDS 2009

AICD International Ballet Awards 2009

13 View St.

SUBIACO

W.A. 6008 

For further information please contact:

 
Margaret Jones +61-(0) 8-9381 2317     djmmjones@y7mail.com

or

 
Margaret Mercer +61-(0) 8-9381 6468 /mobile 041 2024810 / memercer@optusnet.com.au