PSGW 2012 REGISTRATION FORM
NAME: Mail to: P.S.G.W.
1503 E Street
STREET ADDRESS: Bellingham, WA
98225-3007
CITY, STATE, ZIP / POSTAL CODE:
PHONE:
E-MAIL:
REGISTER ME FOR:
|_| Session One: 28 July - 3 August
|_| Session Two: 4 August - 10 August
|_| Session Three: 11 August - 17 August
If the session I have chosen is full, I wish to:
|_| be wait-listed for my session
|_| try for Session _______.
|_| be put on the shortest wait-list.
|_| have my deposit returned.
|_| I haven't attended PSGW before.
|_| Please send me a scholarship application.
|_| I can't attend this year, but please add my name
to next year's mailing list
COMMENTS OR SPECIAL NEEDS (e.g. vegetarian): _____________________
_________________________________________________________________
_________________________________________________________________
DEPOSIT
I enclose $________ Tuition Deposit ($200 per person per session)
($599 balance due at camp)
I enclose $________ in addition to my deposit
as a tax-deductible contribution. (Thanks!)
The total enclosed is $________ (U.S. funds)
© 2011 PSGW
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