NSA-DANCE MAGIC                                      REGISTRATION FORM
COURSE TITLE :     DANCE MAGIC
START DATE:          TBD

LESSON DATES:     TBD
                                        
TIME:                       TBD
       
END DATE :             TBD
     
VENUE"                   BEN LAU'S STUDIO, 80 CHAY YAN ST. #01-06 (TIONG BAHRU ESTATE)
COURSE FEE:        $89.00 (NSA Subsidized fee for 50yrs and above for SG and PR). Those who do not qualify for the NSA subsidy will have to pay the Full fee of $445.00.  Skillsfuture Credits is eligible.

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Name as in IC *
Alias, Christian name, if any.
NRIC No: (Please provide full IC Number) *
Residential Status *
Year of Birth: (yyyy) *
Gender *
Race *
Contact No: *
Email: *
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