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Event Registration
The Business of Writing
Registrant Name
*
First Name
Last Name
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Phone
*
Email
*
Verify Email
*
Fee
*
Quantity
$20
-
Sept 19-Kira Henschel
0
1
2
3
4
5
6
7
8
9
10
10
$20
-
Sept 26-Barbara Struna
0
1
2
3
4
5
6
7
8
9
10
10
$20
-
Oct 3-Barbara Mende
0
1
2
3
4
5
6
7
8
9
10
10
$50
-
Sept 19, Sept 26 & Oct 3 (Member)
0
1
2
3
4
5
6
7
8
9
10
10
$55
-
Sept 19, Sept 26 & Oct 3 (Non Member)
0
1
2
3
4
5
6
7
8
9
10
10
LIST OTHER Attendee(s) (in addition to REGISTRANT)
Please list Full Name
Gift
Is this order a GIFT?
Yes
NAME of GIFT RECIPIENT(S) if applicable
Please list Full Name, Phone and Email