KICKLINE CONTRIBUTION FORM

This order form may be used for both credit card check donations. Print out form, and MAIL completed form with check or credit card information to: NDW, c/o UDMA, 376 MAIN ROAD,GRANVILLE, MA 01034 or FAXthis form (credit card orders only) to 1-413 357-8889. NAME DESIRED ON KICKLINE:      (STUDIO)______________________________      (KIDS)_______________________________ Name of individual placing this order: ____________________________________ Address:_________________________________________ City/state/zip:________________________________________ Phone number:_____________________________ E-mail:__________________________________ Mastercard/VISA number:___________________________________ Expiration date:__________________ Amount being donated: $_____________________   APRIL 21 - APRIL 30, 2006 Kickline Across America    ·    Merchandise     ·    Books & More    ·     Kids' Page    ·     Poster Contest Photography Contest    ·     Delegates 2006    ·    Sponsors    ·     Steering Committee    ·     News 2002 Archive 2001     ·    Academic Project     ·    Mentor Program    ·     Contact Us    ·    HOME        Website maintained by ambrosiaweb Copyright © 2005 by United Dance Merchants of America National Dance Week, c/o UDMA 376 MAIN ROAD GRANVILLE, MA 01034 877-YES4NDW, Fax 413 357-8889, ndw@udma.org