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STUDENT_________________________________Telephone_____________ ADDRESS_________________________________________________ CITY, STATE, ZIP___________________________________________ Email____________________________________________________ I wish to attend the G & M Doll Restoration Seminar held on: ____October 7-10, 2010 Cost of Seminar: $1,695.00Payment Requirements: Send application with deposit of one third($565.00) cost of seminar and make check payable to JoAnn Mathias. Second payment of one third cost($565.00) of seminar due 60 days before date of seminar. Third payment of final third($565.00) cost of seminar (plus any extras if ordered) due 30 days before date of seminar. Payment of equipment package due 4 weeks before seminar. Pay by credit card using Paypal. Mail application to: JoAnn Mathias, Beach Doll Hospital, 6204 Ocean Front Avenue, Virginia Beach, VA 23451-2142.
_____ I wish to order the equipment package -Right/Left Handed (Circle One) Liability:I have been informed that this course of study involves the use of some materials and tools considered hazardous by various determining governments and companies. I ___________________________ do not expect to have any problem using these products and sign this release of any liability against the instructors if injury should occur. Signed___________________________Date____________
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