INSTRUCTIONS FOR FILLING OUT ROSTERS FOR

ADDITIONAL CLUB ENROLLMENT

Please type club rosters on the form provided using the numbers listed below.

1.     Change the year to the current Insurance Year.

2.     Type in complete Affiliate name. DO NOT use abbreviations.

3.     Type in Club name.

4.     Type in date (month and year).

5.     List of additional members.

a.  Alphabetical order with last name first. Do not use nicknames.

b.  Only one person per entry - no couples.

c.  List only the members you are paying for. Don't include members paying through another club or Affiliate.

d. The insurance requires 100% participation, but a dancer need only pay in one USDA member club.

e. Addresses and telephone numbers are not necessary.

f.  DO NOT TYPE OR WRITE the dollar amount being submitted for the number of members. This amount is often not the amount that is transmitted to USDA.

Three copies must be submitted by mail along with appropriate insurance premium.

Any additional enrollment not in this format or having a dollar amount written on it will be sent back for correction.

August 2008