Enrollment
Form , Key
West Travel Writers' Workshop
Your Name:
Street Address:
City, State:
Zip Code
Phone Number
E-mail address:
Check here to
join our mailing list for events
Credit Card :
Mastercard
VISA
Expiration Date(mm/yyyy)
Card Number:
Credit Card PIN number
(3 digit number on the back of the card in the signature
area)
If the name on the card or
the billing address is different from above, please
provide:
Name on Card:
Billing Address:
Dates of the Workshop for
Which You Are Registering
Workshop I
January 30, 31 and February 1st, 2009
click to select
Workshop II
February 6th thru 8th ,
2009
click to select
Enrollment
is on a first-pay basis and is limited to 14. There
is a cancellation fee. If you should cancel within 60 days of the
workshop date, there will be no refund unless the opening can be
filled.
Tuition total to be billed to your
credit card:
Yes, I will bring my own laptop/word processor (required)
I agree
Please confirm that your information is
correct then press the submit button below.
Please, press only once to avoid duplicate orders. Thank
You!
Additional request
or comments
You may enroll online and pay by credit card by
filling out this form and clicking the "submit"
button.
If you prefer to pay by check or money order, please fill out
and then print the form,
and mail it with your check or
money order to :
Travel Writing Workshop,
Key West Heritage House Museum
410 Caroline Street ,
Key
West, FL 33040
Email Us...
( 305)
296-3573
Thank you!