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Dynamic Workshop Registration Form

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Author: YCL

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Registration for Dynamic Writers Workshop April 26th, 27th

Deadline for registration is Friday, April 18th. Registration fee is $15.
If you cannot afford the fee please specify so in the special needs box.

Full name*:
Address*:
City*:	State:	ZIP*:

District:	Best to reach me by:
Primary Phone*:
Secondary Phone:
E-mail*:

* Yes I need assistance with travel arrangements and/or costs.
*No I don’t need assistance with travel arrangements and/or costs

* If you are arranging your own travel, please note your itinerary below:

Arrival Date*

Arrival Time

Arrival Place

Depart Date*

Depart Time

Depart Place

* Yes, I need housing, please make arrangements for me.
* No thanks, I already have housing arrangements (see below).

Housing arrangements already made? If so, where?

Special needs: (like dietary, health, housing preferences, low funds)

to send to Dynamic

*required fields

| Printer-friendly page | Send this article to a friend |

Dynamic Workshop Registration Form

Registration for Dynamic Writers Workshop April 26th, 27th

Deadline for registration is Friday, April 18th. Registration fee is $15. If you cannot afford the fee please specify so in the special needs box.

Deadline for registration is Friday, April 18th. Registration fee is $15.
If you cannot afford the fee please specify so in the special needs box.