2004 Newport Vintage Dance Week

Name(s)

Name(s) (for nametag)

Address

City

State

ZIP

Country

Phone
(day)

Phone
(eve)

E-mail

Registration

My registration partner is:

I am applying without a registration partner.

Accommodations

I would like to share a room with:

Please assign me a roommate.

I would like a single room.

Fees:

 Double Room (Workshop, Room & Board) at $605 per person ($575 before May 31,'05)

 Single Room (Workshop, Room & Board) at $680 ($650 before May 31,'05)

Limited optional additional accommodations for Sunday August 14
(note: this includes dinner Sunday and breakfast and lunch Monday)

$45 (per person) Double Room

$55 Single Room

Fill in and print this web-form; Mail this reservation with deposit (a check payable to CVD for $100 per person) to:

Last updated 24 April 2005/csb