Registration Form
Fall 2005 Semester

Please note that electronic on-line registration is not yet possible. Please print out this registration, fill it in and mail along with payment to:

Jazz Moves
4830-104A Street
Edmonton AB T6H 5Z1

Contact us at: [email protected].

Early Bird Deadline is August 31. Registration Deadline is September 10, 2005.

Name:____________________________________________

Address:_________________________________________

Postal Code:__________________ Phone_____________

E-mail: _________________________________________

Please register me for:

Wed. Beginner Jazz
12 weeks		 _____ Early Bird $132.000
(before Aug 31)		 _____ Regular $144.00
Wed. Int/Adv Jazz
12 weeks		 _____ Early Bird $174.00
(before Aug 31)		 _____ Regular $192.00
Sat. Beginner/Intermed.
Sat. Intermediate Jazz
Mon. Advanced Jazz		By membership through Orchesis Dance Group only Link to Orchesis

Amount Enclosed (payable to Jazz Moves)$_______

How Did you Hear About our classes?
_____ Friend/Word of Mouth
_____ E-mail
_____ Yellow Pages
_____ Campus Rec Guide
_____ Theatre Alberta Ad
_____ Previous Jazz Moves Student
_____ At Orchesis Modern Classes
_____ Posters on Campus
_____ See/Vue Magazine
_____ Internet (pls specify search engine and key words)

_____________________________________________

Mail completed form along with payment to:
Jazz Moves
4830-104A Street
Edmonton AB T6H 5Z1

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