DHDS Summer School 2010 Enrolment Form

Registered Charity Number 270896

Please complete, print and post the this form with your cheque or cheques made payable to DHDS, or completed credit card information to: DHDS Summer School, 83 Longton Avenue, London, SE26 6RF, UK

Do note send credit card details by email.

 I wish to enrol for the 2010 Summer School and enclose

 full fee of £630    deposit of £200  (DHDS members)
 full fee of £650    deposit of £200
the balance of £430 (DHDS members) or £450 (non members) to be paid by 20th May 2010.

Method of payment

 Sterling cheque made out to DHDS    Visa    Mastercard.
Direct transfers to our bank account are possible; details supplied on request.

Please fill in your address below, adding credit card details if appropriate, which must be the same as those known to the card issuer. We would prefer cheques from UK residents but credit cards may be used if wished. Cheques from overseas must be in £ sterling and be free of all charges to DHDS.

Total amount £

  For credit card payments, include 5% surcharge

Full name

Address

Post code

Country

Telephone

email

    Tick this box if you do not want information sent by email 

Card number

Expiry date

  Tick to pay the balance by credit card on this mandate on 20 May 2010

Please debit my account with the total amount shown above.
Signature _________________________  Date 

Class choice: If you wish, please indicate your choice of tutor in order of preference. We will do our best to meet your wishes.
Bruna    Hazel    Jørgen 

If you have not attended a DHDS course or workshop before, please tell us about your dance experience:

The above details will be stored in a database, which will not be made available to other organisations. We may, however, send you information about other DHDS events. If you do not want to receive such information, please tick this box.