Lottery & Registration Form Margaret Zinser

The Southern Flames presents

Margaret Zinser

Saturday & Sunday March 24 - 25 2012

"Bugs and Mazes: Sculpting & Enamel Painting"

$350

Includes Margaret's student kit rental.

Value: $25

Registration Form

Name:

Address:

telephone:

Alternate Telephone (mobile):

Email Address:

**If a second class is added (3/22 -3/23) **

___ I can switch to Thursday/Friday second class, if it is added.

___ I can not switch to Thursday/Friday second class, if it is added

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

Please print out and complete this form. Mail the completed form and your check in the amount of $ 350.00 made payable to “Southern Flames” to:

Southern Flames, Inc

c/o Camille Simmons

2154 Briarwillow Drive N.E.

Atlanta, GA 30345

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For Southern Flames Administrative Use Only Please do not fill in below

Received On _________ Check # __________

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