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Workshops Registration Form

 

Please complete the following information and click submit when you are done. Please note, fields marked with an * are required for submission.

THIS IS A SECURED FORM (Note lock icon in top URL)

Personal and Background Information

First Name:*

Middle Initial:
Last Name:*

Address 1:*

Address 2:

City:*

State:*

Zip:*

Home phone:*

Email Address:

School:*

Grade Level:*

Please select the workshop you would like to attend: *

 CHECK BACK FOR UPCOMING WORKSHOP DATES!
 

 

 

Please select the sandwich you would like for lunch:

Club Sandwich – Ham, smoked turkey, crispy bacon, Swiss, cheddar, lettuce, tomato on sourdough
BLT – Crispy bacon piled high, lettuce, tomato on Texas toast
California Delite – Smoked turkey, Muenster cheese, cucumbers, sprouts with Ranch dressing on whole wheat bread
Reuben – Corned beef with melted Swiss cheese, sauerkraut, 1000 island dressing on toasted pumpernickel
Chicken Croissalad – Chicken salad on a toasted croissant with lettuce & tomato
Tuna Croissalad – Tuna salad on a toasted croissant with lettuce & tomato
Veggie – Lettuce, tomato, onion, cucumber, alfalfa sprouts, sliced pickle, banana peppers, veggie cream cheese & Muenster cheese on a toasted whole wheat bagel sprinkled with herbs and spices

Note any changes to your sandwich (for example, no tomato):

Please indicate your chip preference:

Potato chips
Pretzels

$99 Workshop Fee Payment Options :

Check (mail with printed form)
Purchase Order (mail copy with printed form)
Credit Card

Credit Card Information (if applicable):

Name on card:
Phone #:
Card Type:
Card Number:
Expiration Date:
Type your name in lieu of your signature: