Registration Form
for the Mario Robau Jr. West Coast Swing Weekend

April 30 - May 2, 2004
Syracuse Polish Home, 915 Park Ave.

EventPrepaid
by 4/16 N/A
After 4/16QtyAmount
All-in pass$75$99  
W/S #1 -- Improvisation for West Coast Swing$12$15  
W/S #2 -- Improvisation Part II$12$15  
W/S #3 -- Novice West Coast Swing$12$15  
W/S #4 -- Improving Your Connection (WCS)$12$15  
W/S #5 -- The Technique Class (WCS)$12$15  
W/S #6 -- It's All About Me$12$15  
W/S #7 -- Syncopations$12$15  
W/S #8 -- Advanced West Coast Swing$12$15  
Total Amount 

Friday & Saturday DJ Dances are included in the all-in-pass. Otherwise please pay for dances at the door.

Name1 _____________________________________ Phone: _____________ Email: ___________

Address1 ______________________________________________________________________

Name2 _____________________________________ Phone: _____________ Email: ___________

Address2 ______________________________________________________________________


To register, please print & fill out this form, and mail it with a check payable to SSDS, to
Maria Cirino, 98 Sherwood Lane, North Syracuse, NY 13212

To take advantage of pre-registration prices, your check must be dated & postmarked by April 16th. -- No longer available.


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