www.nbdassociation.com

Membership Form

Name _______________________________________________________________

Dance Name __________________________________________________________

(Would you like your legal name or dance name or both listed in NBDA programs?)

Mailing Address _______________________________________________________ 

 

(Would you like to get NBDA news via email or snail mail?) ____________________

E-Mail Address ________________________________________________________

Web Site Address _____________________________________________________

Telephone ____________________________________________________________

Teacher or Student? ___________________________________________________

Who is your teacher? ___________________________________________________

Are you a musician or vendor? ___________________________________________

Birthday _____________________________________________________________

Membership: $10.00/year. Make checks payable to: Marie Watson 11 Lothrop st.

Beverly, Ma. 01915