Print this attendance form, fill in and send in with your
payment, payable to:
YALLAH DANCE, INC.
282 Magnolia Avenue
Unit# 6
Jersey City, NJ 07306
(Please print. All info will be kept confidential)
First Name: _____________________________________
Last Name: _____________________________________
Email: _______________________________________________
Mailing address:
Street: _______________________________________ Apt.# _________
City: ___________________________ State: ______ Zip:___________
Phone: ________________________ (emergency purposes only)
Event:
DEC 19, 2004 - "The Sensuous Wild Bash: Pure
Party!" DVD Release
Cost:
$45.00 per person payable in advance.
No Refunds.
No Walk-ins, you must call Angeline first at: 201-320-5652.
Amount of payment enclosed: __________
Number of attendees in your party: __________
Kindly specify the other names in your group below, use separate paper if needed:
_______________________________ , _______________________________
_______________________________ , _______________________________
_______________________________ , _______________________________
(If you drink, please don't drive. A friendly reminder from Shamiradance and Yallah Dance Inc.)