LEARNING AT HOME WORKSHOP REGISTRATION FORM
Postmarked one week prior to the event.
Name:_________________________________________________________
Address:_______________________________________________________
______________________________________________________________
If applicable, number of Teens Attending: _____
Names _________________________________________________________
_________________________________________________________
Phone number:___________________________________________________
Email address:____________________________________________________
Name of workshop ________________________________________________
Date of workshop: ________________________________________________
Location of workshop:_____________________________________________
Amount enclosed: ___________
Make check payable to Barbara Mesh and mail to:
Barbara Mesh
2030 Capps Road,
Lake Wales, FL 33898