Blessed Francis Seelos Academy

A North Hills Regional Catholic
Elementary School

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Father Daughter Dance Registration

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  Name REQUIRED Please fill out this field. Please enter valid data.
  
  Email Address REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED Please fill out this field. Please enter valid data.
  
  Name of Special Guest (Father, Grandfather, Uncle, etc...)
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Name and Grade of Student(s) Attending: REQUIRED Please fill out this field.
  
  Number of Tickets ($15.00 per person) REQUIRED 15.0 – 1 30.0 – 2 45.0 – 3 60.0 – 4 75.0 – 5 Please fill out this field.
  
  Would you like to donate $10.00 to contribute to the creation of raffle baskets to be raffled off during the dance? 10.0 – Yes, I would like to donate
  
  General Comments / Song Suggestion for the Dance
  
  Please contact Leiha Lindner or Bridget Goodrich with questions or to help with this event.
  [email protected]
  [email protected]
  
  Total:
  
  Submit
  
  Proceed to Payment
  
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