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Painting Workshops Registration Form

Workshop(s) to which I wish to register:

Workshop with Ljubomir Ivankovic

Workshop with Marie Voyer

Workshop with Carole Bonneau

Personal Information:

Mr.Mrs.

Surname:
Given Name:
Address:
City:
Province or State:
Country:
Postal/Zip Code :
Home Phone Number:
Work Phone Number:
Fax Number:
Email Address:

I am a mobility-impaired person. Please explain:

How did I learn about this workshop:

A Friend

The teacher

The Rêves d'automne's Programme

The Rêves d'automne's Web Site

Other. Please specify:

Comments:

Visa payment:

For security reasons, if you wish to pay with Visa, please contact us.

Payment by cheque:

To complete your registration, please mail your cheque to the following address:

6, Saint-Jean-Baptiste St., Suite 102, 2nd Floor, Baie-Saint-Paul, QC G3Z 1L7
The payment by cheque must be made to the order of COFEC - Rêves d'automne.
You have until September 2nd to cancel without penalties.
If you cancel between September 3rd and September 15th,
we will retain 50% of the total amount. After this date, no refund will be possible

For Information:

Email Address:
By fax: (418) 435-0126
By telephone: : (418) 435-5875 ou 1-800-761-5150