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This form should be forwarded to the Federation at the address below. Any other format is acceptable provided the basic information is supplied. To be returned by Oct.31. Please complete the full form, noting changes from last year, so that we can update the directory.
For a multi-section Club, indicate the level, night, location, and caller/leader for each section. Use a photocopy of this form for each section for clarity.
Please fill in or circle the appropriate words.
Club Name:_________________________________________________________________________________________________
Club City:__________________________________________________________________________________________________
Dance Hall Name & Location:_________________________________________________________________________________
Dance Hall Postal Code: ______ ______
Club Type: Square, Square & Round, Round, Contra, Line, Clogging, Country/Western
Square Dance Level: New Dancer/Basic, Mainstream, Plus, Advanced 1, 2, Challenge 1,2,3,4
Round Dance Level: New Dancer, 2, 3, 4, 5, 6 (usually two level 2/3, 3/4, 4/5, etc.)
Contra, Line, Clogging, or Country/Western Level: _____________________________________
Day & Time: SU, MO, TU, WE, TH, FR, SA Morning ________ Afternoon ________ Evening _______
Frequency of Dancing: Every Week _____ Every Other Week ______ Other ____________________
Club Dances All Year: Yes ____ No___ indicate start _____ and stop __________
Number of Dancers in club: ________ (Census information only - not published)
Caller/Leader/Cuer Information:
Surname: _______________________ First Name: _______ Partner: __________________
Address: ____________________________________________________________________
City: ____________________________ Postal Code: ___________
Phone: (____) _________________ Caller/Cuer e-mail: __________________________
Date Caller/Leader started calling ______________ started for Club _______________
Club Officer/Contact Information:
Same as above: Yes ___ No ___ If no, please provide the following:
Position: _______________________________________
Surname: _______________________ First Name: _________ Partner: __________________
Address: _____________________________________________________________________
City: ____________________________ Postal Code: ___________
Phone: (____) _________________ e-mail contact for Club:___________________
Date Club was formed __________________
Ontario S&RD Federation Membership Return:
Please send this form and your cheque to the Treasurer of the Federation: