Name: ____________________________________________Phone:( )___________________
Address: ________________________________________________________
City, State, Zip: __________________________________________________
Email: __________________________________________________________
LLBWA Member__________Yes__________No
List below classes you would like to take Friday night. Please put them IN ORDER OF PREFERENCE; DO NOT list classes you are unwilling to take.
1. __________________2. __________________3. __________________4. __________________
List below classes you would like to take on Saturday. Please put them IN ORDER OF PREFERENCE; DO NOT list classes you are unwilling to take.
1. __________________2. __________________3. __________________4. __________________
I would like a meal for Friday Night
(# of meals)____@ $4.50 = $_______
Meal includes wraps (sauce on the side), chips & salsa & a fruit cup from the Groove Cafe & a drink.
Send this form, plus a check for $25.00 made payable to Land of Lincoln Basketweavers Association (LLBWA), and a self-addressed stamped business sized envelope to Pat Gustafson, 441 Carlock Road., Carlock, IL 61725 by July 7, 2007.
You will receive class assignments shortly thereafter. Checks for classes must be received by July 30, 2007 to ensure your spot in the class. No refunds for classes will be made after Aug. 3, 2007.
| ___________ | I have enclosed the $25.00 registration fee. |
| ___________ | I would like to volunteer to help as needed. |
| ___________ | I have enclosed money for the Friday night meal (if desired). |
If you have questions, please contact Pat Gustafson at 309-376-7024 or wpgus@starband.com or Marcia Hammerstrand at 309-663-5848 or mshammer@a5.com.