TooHip! Class Registration Form

TooHip!
227 Walnut Street
Peekskill, NY   10566
(914)438-5302
www.TooHipDance.com

To register for classes print this form and mail with your payment to the address listed above.  Please make checks payable to TooHip!. 

Middle Eastern Dance for Beginners

______    10 Mondays   4/21 - 6/30  (no class 5/26)     7-9pm  $199
_____  10 Thursdays  4/24 - 6/26                         7-9pm  $199

Middle Eastern Dance for Intermediate Students

______    10 Tuesdays 3/18 - 5/20                             7-9pm  $199
______    5  Tuesdays 5/27 - 6/24                             7-9pm  $99                                                                                                                                                                        

                                                                                                  Total $ enclosed ________________

Name___________________________________________________________________________

Address____________________________________________ Apt. # ______________________

City, State   Zip__________________________________________________________________

Phone (day)_________________________________ Phone (eve)________________________

E-mail___________________________________________________________________________

How/where did you hear about TooHip! ?_______________________________________
(If referred by current student, please name.)