Dallas Art and Soul Workshops
Printable Order Form

Please put an X next to each workshop you would like to attend. If you would like to include alternate workshops in case the workshops you choose are full, please write "alternate" in the space next to your alternate choices.

Fill out the contact information below, and include a check or money order made out to Art and Soul. Please mail this order form and your check to the address below.

Please also include a $40 one-time registration fee to your total

 


Please also include a $40 one-time registration fee to your total

Registration Information

Shipping Information
(This is the address where we will mail your registration packet )

First Name*
      _____________________________________
Last Name*
      _____________________________________
Address 1*
      _____________________________________
Address 2
      _____________________________________
City*
      _____________________________________
State/Province*
      _____________________________________
Zip Code*
      _____________________________________
Country*
      _____________________________________
Phone
      _____________________________________
Email
      _____________________________________
 
  

Total Due for Workshops:

      _____________________________________

Registration Fee

      $40.00_________________________________

Amount paid with registration (must be at least 1/3 of the total due)

      _____________________________________

 

Comments:

 

 

Please mail to:

Art & Soul
PO Box 484
Corbett, OR 97019