Formed September 2000

                                            Registration Form

Name______________________________________________________

Address_______________________________________ Ph________________

City,St,Zip____________________________________Em_________________

Team________________________Instructor_____________________

Dues for the Clogging Council are 10.00 per year per person.  “Dues are January 1^st to December 31^st”.  Any one from anywhere can join.

Please make checks payable to the: Arkansas Clogging Council 

                                                                c/o Kathey Wilson, CCI

                                                                296  CR   368

                                                                Jonesboro,  AR  72401

For more information contact:   Leona Miller,CCI, President  870-935-4774 arclogger@cox.net

                                                         Kathey Wilson,CCI, Sec/Tres  870-972-1942  iclog2@clogdancing.com

Visit us on the web    www.arkansasclogcouncil.clogdancing.com