NAME(S)      _________________________________________________________


ADDRESS      _________________________________________________________


             _________________________________________________________


PHONE        _________________________________________________________


E-MAIL       _________________________________________________________


FULL EVENING (dance, dinner, and ceilidh):         _____ TICKETS @ $38.00/each          

3 DANCES, DINNER and CEILIDH ONLY:                 _____ TICKETS @ $35.00/each

DINNER and CEILIDH ONLY:                           _____ TICKETS @ $30.00/each

    Dinner will be a buffet.  Vegetarian selections will be available.

DANCING ONLY:                                      _____ TICKETS @ $25.00/each    
   
CEILIDH  ONLY:                                     _____ TICKETS @ $10.00/each 

LATE FEE:                                          _____ @ $5.00/per person
(For registration after 14 February).


TOTAL AMOUNT ENCLOSED:    ________________________
(Please make checks out to RSCDS-Twin Cities Branch)


NEED HOSPITALITY?      Yes       No

IF YES, LET US KNOW IF YOU HAVE ANY PET ALLERGIES, SMOKING PREFERENCES, OR
SPECIAL NEEDS.  ALSO, PLEASE LET US KNOW IF YOU ARE TRAVELLING WITH OTHERS

_______________________________________________________________________

Note:  Accommodations are also available at the Medina Inn, located next door to 
the ballroom.  Details are on the main ball web page.

**IF YOU HAVE A CEILIDH ACT TO CONTRIBUTE, PLEASE DESCRIBE ON THE BACK.**