Since 1952

Enrolment Form:

Please provide the following contact information:
Use the Tab key to move to the next field

If more than one person enrolling, please submit a separate form for each person

First Name
Last Name
Postal Address
Address (cont.)
Suburb
Home Phone
Mobile or Work Phone
E-mail
This e-mail address will be used for confirmation and reminder only
After enrolment you can receive notices of new courses and special offers. Your address will not be passed on to anyone else. Yes I want to receive future news and special offers No I don't want to receive future news and special offers

WHICH COURSE DO YOU WISH TO ENROL IN:

Tick the Course, Level and Day

Starting Date of Course: dd/mm/yy

HOW DID YOU FIND OUT ABOUT OUR CLASSES? (You can select more than one)	Web Google Facebook NZ Herald Ad Local Paper Ad	Yellow Pages Sandwich Board Friend Knew of Us Other

SOCIAL	Ballroom & Latin	Monday 8.00 pm
		Wednesday 8.00 pm
		Saturday 10.30 am

SALSA	Level 1	Thursday 8.30 pm
	Level 2	Thursday 7.30 pm

ARGENTINE TANGO	Level 1	Wednesday 6.00 pm
		Friday 6.30 pm
	Level 2	Wednesday 7.00 pm
		Friday 7.30 pm
MEDAL DANCING	Please contact the studios

Gift Vouchers Available
Can be for any course, private lessons, or dollar value - Valid for one year

www.johnyoungdance.co.nz
P O Box 6189 Wellesley Street Auckland 1141 * Level 3, 54 Wellesley Street West, Auckland
Ph: (09) 373-9000