Workshop Registration Form

	Lake Michigan Sampler Guild Please print: (USE ONE FORM FOR EACH WORKSHOP)
	Workshop:	____________________________________________________
	Date:	____________________
	Name:	____________________________________________________
	Address:	____________________________________________________
		____________________________________________________
	City/State/Zip:	____________________________________________________
	Home Phone:	____________________________________________________
	Work Phone:	____________________________________________________
	Email address:	____________________________________________________

	Please make checks payable to Lake Michigan Sampler Guild. Full kit price is required at registration for each workshop. Teaching fee is due on the day of the workshop. If signing up by mail, send to: Karyn Pechinski 1918 Fays Lane Sugar Grove, IL 60554 Phone: 630-466-7791 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Kit fee: Check #____________ Amount _____________ Date _______________

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