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Lottery Form

 Name:                                                                                                              

Address:                                                                                                          

Telephone:                                                                                                       

Alternate Telephone (mobile):                                                                           

Email Address:                                                                                                 

  Lauri Copeland Class Preference (only check one):

               Only able to attend October 23 & 24, 2004 (Saturday / Sunday)

              Only able to attend October 25 & 26, 2004 (Monday / Tuesday)

               Can attend either session, prefer Sat/Sun – You may be placed in either class.

               Can attend either session, prefer Mon/Tues – You may be placed in either class.

 Do you want to be on the waiting list if your name is not drawn for a class session (circle one)?  yes    no

 If you will not be at the meeting for the lottery, please print out and complete this form, then mail it with a check to “Southern Flames” for $225 to:

Southern Flames

Box 11A

311 Peachtree Hills Avenue

Atlanta, GA  30305

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