Online Registration Form for
COLLAGE TECHNIQUES & CREATIVE EXPLORATION 2012
 with Jonathan Talbot
Tuesday & Wednesday, May 15th & 16th, 2012 + Optional Extra Day May 17th.
Elaine Larson's Studio, Petaluma, CA

Instructions: Fill out the form below and click the "SUBMIT REGISTRATION" button. You will be then be taken to a payment page where you can pay by credit card or PayPal or, if you prefer, you will be given the option of sending a check. You will receive confirmation of your registration by both regular mail and e-mail (please allow 24 hours). To register by phone, or for additional information, call Jonathan Talbot at 845-258-4620 (9 AM to 6 PM Eastern time please).
Name: Each registrant will receive a letter in advance of the workshop containing directions, suggestions of what to bring with them, and more. Participants who decide to come empty handed will find that all materials and tools needed for a full and enriching experience are provided.
E-mail Address:
Company (if applicable):
Street Address:
City: Please check all applicable boxes
State (Province / Department):

Include me in the Optional Extra Day on May 17th

Zip (or Postal) Code: Please send accomodations information
Country: Please send travel Information
Phone: I prefer vegetarian snacks
Fax: I am an omnivore

Comments, Questions
or Requests:



ONLINE-WS-REGISTRATION FORM REV. FEBRUARY 2012