Please type club rosters on the form
provided using the numbers listed below.
Change the year to the
current Insurance Year.
Type in complete Affiliate
name. DO NOT use abbreviations.
Type in Club name.
Type in date (month and year).
List of additional members.
order with last name first. Do not use nicknames.
one person per entry - no couples.
only the members you are paying for. Don't include members paying
through another club or Affiliate.
insurance requires 100% participation, but a dancer need only pay in one
USDA member club.
and telephone numbers are not necessary.
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
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.