Workshop Registration

hank you for your interest in my GreatPhotography Workshops. I know that you'll have the time of your life.

Please fill out all information carefully.

First Name
Last Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Work Phone
Home Phone
Cell Phone	**
E-mail

** Be sure to include the cell phone number of the phone you'll have at the workshop.

Choose one of the following Workshop Locations:

Texas Workshop $595
Grand Teton National Park $595
Canadian Rockies $595 (Session 1 9/10-14) Sold Out
Canadian Rockies (Session 2, 9/14-18)
Digital Chicks on the River $195 Sold Out

Payment Options?

Pay full amount now
Pay down payment now, balance 60 days prior to event

Are you an Alumni?
If so, indicate which Workshop(s) that you attended.

Year Location

Payment Information

Credit Card:	VISA MasterCard
Name on Card.
Card Number:
Exp Date:	-- mm/dd/yy
Billing Zip

General Information

Often students would like to share rooms or rides. The following information would be helpful. Please note I do NOT handle reservations but this information will help if students inquire into whether I know of others who may be willing to share a room.

Would you be willing to share a hotel room with another workshop participant?	Yes: No:
Can I share your contact information with other students in the same workshop?	Yes: No:

Comments

[eligible for a discount?]

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