REGISTRATION PROCESS: (1) Enter Student Information     (2) Print Receipt     (3) Pay Online or Mail Check
 
SALSA (Beginner & Up)
Class Dates: WEDNESDAYS  Starting:  September 8 - October 27, 2010, 8-weeks
Class Time: 7:45 PM
Class Location: BDC Woodbridge Ballroom, Woodbridge VA
Class Instructor: Mas Nishida
Price: $ 104
* Required fields
* First Name:
* Last Name:
* Leader or Follower:
* Street Address:
* City:
* State:
* Zipcode:
* Home Phone:
* Work Phone:
Cell Phone:
* Email:

 
Complete the form below to register another person for the same class. Leave the form blank if you are only registering one person and complete the payment information at the bottom of the form.
First Name:
Last Name:
Leader or Follower:
Street Address:
 City:
 State:
Zipcode:
 Home Phone:
Work Phone:
Cell Phone:
Email:

 
Payment Information
* Payment Type:
Total Amount $: .00
Comments/Notes: