INSTRUCTIONS FOR FILLING OUT

CLUB ROSTER

Please type club rosters using the numbers listed below

I.      Your Affiliate's name. DO NOT use abbreviations.

2.      The Club's name.

3.      Roster and date.

4.      List of 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. Non-affiliated clubs such as those in Associated Square Dancers do not count.

e.  Addresses and telephone numbers are not necessary.

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

g. Form is two pages long. You do not need to print both pages if the list of members does not go onto second page.

Three copies of the Roster must be submitted by mail with the Initial Enrollment along with the appropriate payment for insurance premium.

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

August 2008