Master Classes Fundraiser Registration Form
"Spend a Day with the UConn Tap Team
Saturday, November 15, 2008
Session 1: 11:00 AM - 2:00 PM
Session 2: 1:00 PM - 4:00 PM
UConn Campus in Storrs, CT
Name: ______________________________________________ Age: _________________
Parent's Name: _____________________________________________________________
Address: ___________________________________________________________________
Home Phone Number: _________________________ Cell Phone: _____________________
Form of payment (please circle one): Cash Check
Please send this form, the release form and payment to:
Leandra Smith
University of Connecticut
107A Brown Hall
Storrs, CT 06269
Any questions regarding the event can be directed to Leandra Smith or Melissa Eseppi via e-mail at leandra.smith@uconn.edu or melissa.eseppi@uconn.edu, or phone at 860-874-3443 (for Melissa).