LEARNING AT HOME REGISTRATION FORM
Postmarked one week in advance of the workshop date.
Name(s):_________________________________________________________
Address:_________________________________________________________
_________________________________________________________________
Phone number:____________________________________________________
Email address:____________________________________________________
Name of workshop _________________________________________________
Date of workshop: _________________________________________________
Location of workshop:_______________________________________________
Single Registration: $43
Married Couple Registration: $53
_____ Check if your teenager will also be attending (free of charge)
Amount enclosed: ___________
Make check payable to Barbara Mesh and mail to:
Marcy Schaller
4228 SW 20th Ave.
Cape Coral, FL 33914