SE Competition Organizer Donation Payment

Southeast Competition Dancer Donation Payment Form
We are grateful to all of our competition organizers in the Southeast. To the extent your competition collects a SDUSA fee for each dancer (often $1 or $2 per dancer) or wishes to make a general contribution, this form will enable you to easily submit the donation to the Region.

While this form allows for payment by credit card, you can also fill out this form so data can be collected and mail a check made payable to Southeast SDUSA and mail it to:

Margo Rosenthal, Treasurer, SE SDUSA, 255 Marchand Court; Sandy Springs, GA 30328.

We appreciate your time and effort in supporting our Region!

Thank you!
Competition Name
Location

Street Address

Street Address Line 2

CityState

Zip Code
Date of Competition

MonthDayYear
Date
Total number of dancers entered
Competition Organizer:
Name(s)
E-mail
Phone Number

Area CodePhone Number
Total donation for Region
Ex. $50.00
Payment Method

My Products

Contribution$1.00

Select the number from the drop down menu that coincides with the total donation amount you would like to make. For example, if your donation is $100, please select 100 as the quantity or if your donation is $25, please select 25 as the quantity.

Quantity

Total $0.00

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Thank you!

We appreciate your generosity and support of the Southeast Region!
Should be Empty:

Southeast Competition Dancer Donation Payment Form

My Products

Thank you!