LEARNING AT HOME REGISTRATION FORM
Postmarked one week in advance of the workshop
Name(s):_________________________________________________________
Address:_________________________________________________________
_________________________________________________________________
Phone number:____________________________________________________
Email address:____________________________________________________
Date of workshop: _______________
Location of workshop:_______________________________
Single Registration: $40
Married Couple Registration: $50
Amount enclosed: ___________
Make check payable and mail to:
Barbara Mesh
2030 Capps Road
Lake Wales, FL 33898