World Dance Alliance
GLOBAL MEMBERSHIP
Information and Form

Global Membership is available for individuals and organizations who are interested in joining WDA but who are located in a region, country, or continent for which there is no chapter or network. Please complete the following form in its entirety.
This form is to register online AND submit payment electronically using Visa or Mastercard
Questions? Please contact Ereck Jarvis at jejarvis@wisc.edu

Today's Date  

Organization name or Individual Member's Last/Family name First/Given name(s)

HOME:

Home Address 

City   State or Prov Mail Code Country

Home telephone   Home fax Home email

BUSINESS OR WORKPLACE:

Business or workplace name   Your title

Business Address 

City   Sate or Prov Mail Code Country

Business telephone   Business fax Business email

Dance Area Specialty

Check One: Membership Renewal New Member

Check One to indicate Membership Type (in US$):

Standard Memberships:
Individual earning under $25,000 - $10 contribution
Individual earning $25,001 to $50,000 - $35 contribution
Individual earning $50,001 to $75,000 - $50 contribution
Individual earning over $75,001 - $70 contribution

Organization $70 - may have five (5) members participate in WDA activities at member rate 

Please send mail to (check only one): Home Address Business Address

Please send e-mail to (check one or both): Home email address Business email address

I would like to participate in the following WDA Global Networks:

Creation and Presentation Education and Training Management and Promotion Research and Documentation Status and Welfare

TOTAL DUE $
(Please make a note of your total amount due before clicking SUBMIT. You must reenter this amount on a subsequent page along with your credit card information)

SUBMIT Form and continue to PAYMENT

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