Registration

Links

Please print out this class registration form and send along with your check or money order to:

Keepers Kustom Quilting
1012 Long Road
Centralia, WA 98531
USA
Telephone/Fax: (360) 736-4142

After we receive your deposit, we will send you a confirmation letter including hotel information, directions to the studio, class times and required supplies.

NAME_____________________________________DATE_______________________

ADDRESS_________________________________ STATE____________________

ZIP______________________________PHONE______________________________

EMAIL____________________________________WEB PAGE___________________

MACHINE________________________________STITCH REGULATOR_________

MACHINE QUILTING____________YRS.

BUSINESS NAME______________________________________________________

CLASS____________________________________CLASS DATES________________

HOSTESS__________________________________LOCATION___________________

SPECIAL NEEDS________________________________________________________

_______________________________________________________________________

************************************************************************

OFFICE USE ONLY

DEPOSIT_________________________________DATE RECEIVED______________

CONFIRMATION SENT___________________ DATE_________________________