Registration Form – Journaling in Words and Images

REGISTRATION FORM: JOURNALING IN WORDS AND IMAGES – SPRING, 2010

        Two all-day Saturday sessions: April 10 and April 17.
        TIME: 9:30 am – 3:00 pm
        PLACE: Linda Passman’s studio

        Fee: $195 covers both days. Bring a bag lunch.
        Questions? Email Carol at: cd.henderson@gmail.com

NAME_____________________________

ADDRESS_____________________________________

_________________________________________

       HOME PHONE______________

       CELL PHONE_______________________

       EMAIL____________________________________________

       EMERGENCY CONTACT PERSON_____________________

       CONTACT’S PHONE NUMBER:__________________________

       Full payment is required with registration  $_______________

      
Make checks payable, and send completed form, to:

        CAROL HENDERSON
        804 WOODLAND AVE
        CHAPEL HILL, NC 27516

        919-942-2127

        
PLEASE NOTE: YOU WILL RECEIVE AN EMAIL CONFIRMATION
WITH DIRECTIONS AND A LIST OF SUGGESTED SUPPLIES ONCE
WE HAVE YOUR FORM AND CHECK FOR PAYMENT IN FULL. 

THANKS.,

Carol