Registration for Starved Rock Day of Weaving 2006 
May 16 

Name: _________________________________________________________

Address: ________________________________________________________

City, State, Zip: __________________________________________________

Phone Number: __________________________________________________

Email: __________________________________________________________

Note: Registration fee is $30 without kit (pattern included).

If you'd like to order a handle, please include $16 for each.

If you'd like to order a tie-on, please include $4 for each.

Kit fee is $30- including materials, handle & pattern.

Registration fee ____________________________________ $30

Handle/base(s) __________________ quantity _____ @ $16 each = ___

Garden tools tie-on ______________ quantity _____ @ $4 each = ___

Kit fee _______________________ quantity _____ @ $30 each = ___

Total included ____________________________________________________

Hot entree __________________ Chicken Parmesan ______ or,

Croissant choice (circle one): Chicken Salad, Turkey, Beef, Ham

Send this form and a business sized, self-addressed, stamped envelope to: Debbie Smith, 100 Forest Place #1501, Oak Park, IL 60301

If you have any questions, please contact Debbie at (708) 358-1982 or email her at dasmithrdh@aol.com