NEW SUMMER SESSION!
Poetri’s Poetry Workshop Registration Form


(First come first serve basis)
(1) Wednesdays – Aug 10-31, 2005 5pm-7pm
(2) Wednesdays – Aug 10-31, 2005 8pm-10pm
(3) Thursdays – Aug 10-31, 2005 5pm-7pm
(4) Thursdays – Aug 10-31, 2005 8pm-10pm

($100.00 if registered by June 28, 2005)
($130.00 if registered after June 28, 2005)


· Registration is strictly limited to a first-come, first-served basis.

· A non-refundable $50.00 or $65.00 (depending on date of registration) per person deposit will hold your reservation, with balance due the first day of class.

· You can register by filling out this form and mailing it with your deposit to:

PoetriWhere
ATT: Poetri Workshop
PO BOX 9033 Ontario, CA 91762
Make checks payable to Juren Smith

· You may register through paypal.com sending the money to account poetrithepoet@hotmail.com. And emailing the completed registration form.

· Only checks or money orders accepted for reservation. For more information call (909) 725-2863


POETRI'S POETRY WORKSHOP REGISTRATION FORM
Please select one option below:

Wednesdays - Aug 10-31, 2005; 5pm-7pm
Wednesdays - Aug 10-31, 2005; 8pm-10pm
Thursdays - Aug 10-31, 2005; 5pm-7pm
Thursdays - Aug 10-31, 2005; 8pm-10pm
Enter Your Name:
Enter Your Address:
City
State
Zip/Postal Code