Registration for 6-Day Kaleidoscope Pendant Workshop, Racine, WI

Name*

FirstLast

Email*

Phone

Your City and State*

Number of people in your party (for lodging)*

One person
Two people

Are you interested in sharing a room with another attendee?*

Yes
No

Briefly describe your level of experience with polymer clay*

Questions/Comments

Indicate how you are paying your (non-refundable) $75 deposit*

Check (Mail to address below)
PayPal (I will send you an invoice)

Your registration will be confirmed once your deposit has been received.

Please send your check, made payable to Carol Simmons Designs, to:

4900 E Ridge Dr
Fort Collins, CO 80526

Please write your email address on the check.

Registration for 6-Day Kaleidoscope Pendant Workshop, Racine, WI

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