REGISTRATION FORM
for Salsa Courses
Please Print and Mail to:
Coal Country Traditions
c/o Robert E. Rogers
1998 Monongahela Ave.
Pittsburgh, PA 15218
Make checks payable to “Coal Country Traditions”.
Salsa I (6 weeks) $50 (see discounts below)
Salsa II Intensive (3 weeks) $25 (see discounts below)
Salsa III Intro (3 weeks) $25 (see discounts below)
Yes, please sign me up for Late Fall 2002
Salsa Essentials I Salsa II Intensive
Salsa III Intensive (circle one)
I have enclosed $_________
Name (1)____________________________________
Circle One: Lead or Follow
Name (2)____________________________________
Circle One: Lead or Follow
Address ____________________________________
City _________________ State ______ Zip ________
Phone __________________
Email ___________________