registration form_ peter pearson workshop
DESCRIPTION
Registration form for Peter Pearson Workshop held at Quarterman Ranch.TRANSCRIPT
Peter Pearson Icon Workshop Registration November 5 – 7, 2010 Quarterman Ranch
Name ____________________________________________________________ Address ___________________________________________________________ Email _____________________________________________________________ Daytime Phone _____________________ Evening _________________________ Special needs _______________________________________________________ ___________________________________________________________________
Registration fee is $325 and includes all supplies, lodging and meals. $75.00 Deposit is required with this registration form postmarked by October 20
Space is limited to register TODAY!
Please make checks payable to Quarterman Ranch or fill out the VISA/MasterCard credit card information below.
Credit Card Information: Name as it appears on the card: ________________________________________ Credit Card Number _________________________ Expiration ________________ Amount _____________ Signature ______________________________________ Zip code where billing statement for credit card is mailed: ___________________ Quarterman Ranch (806) 383‐6878 Office 232 East Cottonwood Street (806) 383‐4056 Fax Amarillo, Texas 79108 (806) 584‐1995 Jamie’s Cell