EmailMe Form - Indy Dancers - Membership Application

Indy Dancers, Indianapolis Indiana USA
www.indydancers.com
(317) 767-5665

"Dancing just for the fun of it since 1983"

Your Name *
Prefix First Last
Date *
MM / YY
Phone *
### - ### - ####
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

This is for internal Indy Dancers Club use only and NEVER SHARED - Credit card users will be redirected for payment on next screen.
Thank You!
Tell us your dance interests: Example - favorite song, dance, and other hobbies. Thanks!
Yearly (12 mo) Membership *
Club Yearly - $30.
Renewal - $30
Your Email *

Confirm Please


Total	$30.00

Indy Dancers Inc. is a Federal & State registered not-for-profit 501c7 coporation.
PO Box 2106, Indianapolis, IN. 46206-2106