WEST COAST WEEK
Print this page, fill in the necessary information, and fax to:
818.752.8386 or mail to:

MDC - WEST COAST WEEK
5113 Lankershim Blvd.
North Hollywood, CA 91601

PART 1: CONTACT INFO PLEASE PRINT NEATLY. THANK YOU.

Name___________________________________________________________

Address_________________________________________________________

City_____________________________________State/Prov______________

Zip/Postal_________________________Country_______________________

Phone ________________ Cell __________________ Fax________________
Email __________________________________________________________
Which Dance Studio Are You From?___________________________________


For more information, pricing, and availability,
please call Jin at (818) 818-753-5081



PLEASE READ: Please fax or mail this form to the number/address above. You will be contacted as soon as possible regarding your application. If you have any questions about this application, please call Jin at 818-753-5081  during business hours. Please DO NOT send money with this form. Millennium is not responsible for delayed/lost mail, mechanical failures of the Postal Service, and/or electronic failures of fax transmissions.