LEARNING AT HOME REGISTRATION FORM
Postmarked one week in advance of the workshop date.
Name(s):_________________________________________________________
Address:_________________________________________________________
_________________________________________________________________
Name(s) of your teen(s) who will be attendiing with you (age 13 and older) #____
_______________________________________________________________
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
P.O. Box 150188
Cape Coral, FL 33914
Remember to bring a 3 ring binder in which to place your Resource Packet.