Please print and mail this form to the address below. If you are a new member, once we receive your application, you wil be emailed login and password instructions to the Member web site.

Membership Form

International Choreographed Ballroom Dance Association
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ICBDA Membership Dues (per address)

U.S.A.

Canada

Overseas

$21

$23

$26.25

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   New Member
   Renewal

   Dancer
   Instructor

National Carousel Club Dues (for NCC leaders)

Per Carousel Club

NCC # ______

NCC # ______


$10

$10


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  TOTAL   $
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Please Print

Name ____________________________________________ Phone ________________________________

Email Address(es) ________________________________________________________________________

Address ______________________________________________________ Country ___________________

CHECKS or MONEY ORDER Payable in U.S. FUNDS to:
International Choreographed Ballroom Dance Association

MAIL TO:
Jerry & Louise Engelking
1751 County Road CC
Muleshoe, Texas 79347

email: DANZNDUO@FIVEAREA.COM   phone: 806-925-6434