Co-Creative Gardening Study Group 2010
Registration Form

Name:

Address:

City:						State:				Zip:

Home Phone:					Work phone:		

Cell:						E-mail:


(Please circle above the preferred way/s of contacting you.)



Registration fee:  

Date Paid______

Check or Cash_____

Check #______


If you have dire financial hardship and wish to take the class, please talk to us.

If you are taking the class through open enrollment, talk to us.

Notes:









Please make check or money order payable to Jennifer Vyhnak and bring to class or mail to Earth Healing Institute, 8 Mountain Street, Bristol,VT, 05443.  Thank you.