La Soiree Dance Hall

Request Services

Please complete the form below to request our services. Please answer all the questions on this form so we
can better serve you. As soon as we receive your information, we will contact you to setup a time for you to come and visit our hall.
Thank you very much for your interest in La Soiree Dance Hall.

* First Name:

* Last Name:

Organization:

Address:

City:

State/Province:

Zip Code:

* Phone:

Fax:

* E-mail Address:

Type of Event:

Number of Participants:

Requested Date:

Alternate Date:

Additional Notes:

How would you prefer we communicate with you?

  Phone

  Fax

  E-mail