Online Forms – USAWest New Mexico

Name ~ Preferred Name on convention badge in (Parenthesis) *

First

Last

Single adult registration $70 until June 25, 2023

Would you prefer a pin or magnet on convention name badge? *

Pin Magnet

Dance Partner Name ~ Preferred Name on convention badge in (Parenthesis)

First

Last

Single adult registration $70 until June 25, 2023

Would you prefer a pin or magnet on convention name badge?

Pin Magnet

Email Address *

Phone

Address: Street *

For sending a convention ribbon.

Address:City, State and Zip Code *

For sending a convention ribbon.

What level do you square dance? *

What level do you round dance?

What do you dance?

Round Dance Syllabus (Flash Drive Only)

Yes $8.00

Name of Youth #1 ~ Preferred Name on convention badge in (Parenthesis)

First

Last

Single youth registration $35 until June 25, 2023

Would you prefer a pin or magnet on convention name badge?

Pin Magnet

Name of Youth #2 ~ Preferred Name on convention badge in (Parenthesis)

First

Last

Single youth registration $35 until June 25, 2023

Would you prefer a pin or magnet on convention name badge?

Pin Magnet

Name of Youth #3 ~ Preferred Name on convention badge in (Parenthesis)

First

Last

Single youth registration $35 until June 25, 2023

Would you prefer a pin or magnet on convention name badge?

Pin Magnet

Name of Youth #4 ~ Preferred Name on convention badge in (Parenthesis)

First

Last

Single youth registration $35 until June 25, 2023

Would you prefer a pin or magnet on convention name badge?

Pin Magnet

Message / additional comments