Online Class Registration
Parent's Name:
Student's Name:
Mailing Address:
Phone:
Email:
DOB & Age of Student:
How Did You Hear
About Us?
List Class
Program,
Day & Time:
Questions?
We will email you a confirmation as soon as
we process your request.
Please mail a $10.00, non-refundable deposit
to hold your place in the class
(deposit will be applied to your 1st month's tuition)
PA Dance Network
P.O. Box 420
Analomink, PA 18320
570-426-6855
Include a copy of this form with your
check or money order.
Looking forward to seeing you for class!
Dance for the Joy of It!
our physical location is
700 Milford Road East Stroudsburg
