Discover Writing Voice Workshop with Barry Lane

You may register for Barry Lane's Workshops using this form

Workshop Location and Date - Please select your choice
*required*required

Registration Fee is $185.00 per person
(Note: If 3 or more from the same school register at the same time, the fee is $175 per person)
Includes refreshments, handouts, and attendance certificate

 Note:  If you are using a company or school purchase order, please mail it to us before the workshop date.

DISCOVER WRITING COMPANY
PO Box 264
Shoreham, VT 05770

Please indicate the purchase order number here

School Purchase Order Number

Then complete the rest of this form as needed.

OR

I will be paying by (select one) *required
Credit Card    Check Mailed to Discover Writing Company

If paying by credit card, please complete this information

Visa   Master Card

Credit Card No.

Expiration Date

If you are interested in CEU's etc. and they are available for your state,
all of the information will be provided at the seminar.

Please complete the full information requested at the bottom of this page.
All additional registrants should supply the abbreviated information requested here

Registrant #2      Position/Grade

Registrant #3      Position/Grade

Registrant #4      Position/Grade

Registrant #5      Position/Grade

School Affiliation

Street Address (School)          

City      State      Zip

Email

One of the attendees (Registrant #1 ), please complete the following information.

Full Name *required

Home Address *required

Home City *required

Home State *required    Home Zip *required

Home or Work Email *required

Work Phone *required      Home Phone *required

Number of people attending from your school or company

Please use this space for additional information or comments

Thanks for Registering - We look forward to meeting you!