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EDUCATION FORM TO REQUEST A CLASS

Name: ____________________________________________________  Date: _________________

Class: _____________________________________ Instructor: _____________________________

Date: _____________ Cost: _____________ Attention: ____________________________________

Please include your check and mail to:

PEACE RIVER QUILTERS' GUILD, INC. - P.O. BOX 512265 - PUNTA GORDA, FL. 33951

to the attention of the Contact Person in charge as noted in the Newsletter / Web Page

OR

You may give this form and payment to the Contact Person.

Members will be added to the class list upon receipt of their name and payment.