Back to Announcements     Class Info     Bio and Beads

 

The Southern Flames present  Julie Ferguson

Reactive Glass

 

Lottery/Registration Form

Sat& Sun April 25-26-2009

 

 Name:                                                                                                              

Address:                                                                                                          

                                                                                                                       

Telephone:                                                                                                       

Alternate Telephone (mobile):                                                                           

Email Address:                                                                                                 

 

                    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, complete, then mail the completed form and your check in the amount of $220.00 (Members) or $245.00 ( Non Members) made payable to “Southern Flames” to:

Southern Flames

c/o Martha Fuerst

2679 Mercedes Drive NE

Atlanta, Georgia 30345-3974

 

              NOTE:  CHECKS AND FORMS MUST BE RECEIVED BY Friday, Feb 20  (if mailed to Martha).

-------------------------------------------------------------

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

Received On _________   Check # __________

 

-------------------------------------------------------------

Back to Announcements     Class Info     Bio and Beads