Name/s:

Venues:

Wesley Conference Centre - Suter Room
220 Pitt Street,
SYDNEY
Right Side of Piccadilly Arcade
(Between Park & Market Streets) 

Preferred Date:

  Monday 20th September 2010
        7.00pm to 8.00pm  
       

Gender:

    Male

    Female

Do you intend to come with a partner?

Yes            No

Partners Name   

Contact Phone Number   

Email Address: 

How did you find out about 'Club de Tango'?

    Completed "Club de Tango" Beginner Course

    '9 to 5' Magazine

    Sydney Morning Herald

    Sydney Central

    Dance Network

    Salsa Newcastle

    The Star - Newcastle

    Sydney Tango

    Web Search

    Radio

    Poster

    Sticker

    Friend

    Other 

Would you like to be included on our email list?

Yes            No

Payments can be made at either venue during class or Milonga, Direct Deposit or cheque made out to 'Peter Waller' can be posted to:

Club de Tango
P.O. Box 814,
BROADWAY  NSW  2007

NOTE: All information will remain confidential and is only required for the purpose of organising class sizes