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Chicagoland Chapter
of USA Dance
April in Paris
Dinner Dance and Showcase
Saturday, April 28, 2012
Ticket Reservation Form
for Singles, Couples or Groups |
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Reservations will not be
considered complete without full payment.
Name
Use a separate line for each person |
Membership
Number |
Number
of Tickets |
Cost
$65 Member
$70 non-Mbr |
A. Chicken Entrée
B. Salmon Entrée
C. Vegetarian Entrée |
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A.
B.
C.
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Total |
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$ |
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Reservations only – no tickets sold at the door.
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Please make checks payable to
USA Dance, Chicagoland Chapter #2001
[include a self-addressed stamped envelope]
Send to Susie Johnson
10 Wildwood Drive North
Prospect Heights, IL 60070-1043
for more information call 847-541-1585 |
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