Name:   

Address:

County:       City:      State:        Zip:       

Phone:        Email Address:     

Days Attending?    Both Days ($75) Friday Only ($40) Saturday Only ($40)   

Do you have a Sponsor?  Yes No  

                                    If Yes, Sponsor Name & Address:      

Do you have any special needs (including day care)?  Yes No    If Yes, please specify:

Will you be displaying in the Photo Gallery?   Yes No

Will you be displaying in the Quilter's Corner?  Yes No

Please choose two (2) of the following workshops to attend on Friday:

  What's My Weed?   Medicare Made Easy   Leadership in Small Communities   In-Laws, Outlaws

Please choose two (2) of the following workshops to attend on Saturday:

  Helping Youth Succeed   Entrepreneur Success   What's Wrong with My Tree?   Annie's Round Table