2009 blue door studio Pre-Registration Form


Name _____________________________________________________ Date ____________________



Address _____________________________________________________________________________



Phone Number ______________________________________________________________________



E-mail _______________________________________________________________________________



______  One Day Encaustic Workshop                         Pre-registration fee:  $50.00*


______  Collage and the Altered Book Workshop        Pre-registration fee:  $35.00*


______  Bookmaking Workshop                              Pre-registration fee:  $25.00*


*Required to hold your place in class.

Supply list and directions mailed upon receipt of registration fee.

Please make ALL checks payable to CLARE MURRAY ADAMS

Mail to:

blue door studio
P.O. Box 125
Southington, Ohio 44470

*Balance of payment due on the day of the class.