1421 S. Park St
Madison, WI 53715
info@madisonmultidance.com · 608-438-6632

Your Name
Your Email Address
Phone Number
Select Class or Workshop	Fall 2010 basics (September 2- October 28) level 1a level 1b level 2a level 2b level 3/4 technique Workshops TBA
Payment Option	PayPal In Person
New Student?	yes no
Address
City, State, Zip
Preferred method of contact	phone email
Add to the Yahoo group?	yes no
Add to Madison Bellydance Alliance google group?	yes no

Class Registration

Step 1 - Personal Information