Registration Form

Name_____________________________________________________________________

Street Address______________________________________________________________

Town______________________________________      State___________  Zip_________

Tel. No.________________________  E-mail_____________________________________

     Emergency No. ______________________________

     Where did you hear about this conference?________________________________________

Do You Have any special needs (i.e. Wheel Chair Access, food, etc)?

_________________________________________________________________________

Choice of Banquet Meal: Regular ___________     Vegetarian __________**

**Currently the Vegetarian Banquet Dinner Includes Milk and Cheese**

Choice of classes:

All Classes this year are 3-day classes

   Class:  1st choice ________________________________________________

             2nd choice ________________________________________________

     

No class confirmations will be issued until fees are paid in full.

Registration Fees

Please copy and paste this Registration Form, completed, into an E-mail and send it to:

Diane Little

Olough@aol.com

42 Juniper Rd   

Placitas, NM  87043

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