Surface:Layered
Registration Form
________________________________________________________________________
Name (Please print) _____________________________________________________________________________
Address _____________________________________________________________________________ City & State
_________________
Zip
(__________) ____________________________
Telephone
_______________________________________________________
E-mail

Use one form per person only. Photocopy this form for friends or your records.
Indicate your 1st and 2nd choices in left column. (NOTE: DO NOT list a class as an alternate unless you are willing to accept it if your other choices are full.) Include payment for your 1st choice class. Classes not meeting minimum requirements may be canceled. No telephone registration accepted.

Northern Arizona University is teaming up with the Coconino Community College to offer affordable housing within their dorm rooms at 40$ a night.  I am interested in affordable housing for___________ nights.

I would like to participate in the workshop participants slide show on Thursday July 31 2008.___________
Please mail up to two slides (with or without detail shots) of your best work, to be recieved by July 14, 2008 to Melanie Testa P.O. Box 36 Flagstaff AZ 86002. Please send a three line statement for each work of art as well. This should include materials and date completed. Also include a S.A.S.E if you cannot collect your slides in person after the presentation.

I plan to attend the Trunk Show Presentaion given by Melanie Testa (at an addition cost of 5.00)

I plan to attend the Carol Soderlund Lecture and Dinner event on Friday August 1(at an additional 40$ cost, general public is welcome to attend) ____________________

Total amount due.............................................................................................................................................................
Check enclosed for total payment due by July 23, 2008
Signature
....................................................................................................................................................................
Without your signature on the preceding line, your registration cannot be processed.
Cancellations: Please direct inquiries about our cancellation policy to

Lee Vadnais 928-526-7654 Lee.Vadnais@COCONINO.EDU

Sue Minger 928-526-7644 susan.shaw.minger@coconino.edu

Make checks out and mail completed form to:

Coconino Community College
C/O Lee Vadnais
3000 N. Fourth St.
Flagstaff, AZ 86004-18925

Supply lists will be available in the mail by upon receiving registration. Kit fees have been included in the price of the class