Inscription classes winter 2014 Stefan & Komala

This registration form is personal, ask your dance partner to register him/herself!

Name (required)

Phone (required)

Email (required)

Registration for class(es)

Workshop dates: 29/1, 5/2, 12/2, 19/2, 26/2, 12/3, 19/3, 26/3, 2/4, 9/4, 23/4, 30/4

Total Bruto

Please make a bank transfer for the total amount before the beginning of the courses to bank account number 1290.52.604 on the name of J.F.L. Diepens, with a reference to 'classes authum 2013 Stefan & Komala / Marian'.

Bank codes for payment outside of The Netherlands
IBAN: NL45 RABO 0129 0526 04
Postal code: 5663 EM
More info


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