November form

Jane Harrop's November Workshop

20th November 2009

Application Form

Please complete the form, and

(1) If you are paying by £sterling cheque, print the form and post it to the address below, enclosing

a self adhesive self addressed label.

(2) If you are paying by PayPal, ask for a PayPal invoice and click the Submit button at the bottom

of the page to send the information to Jane.

Name

Address line 1

Address line 2

Town/City

County/State

Post/Zip Code

Country

Please send me a Musical Interlude kit in

Completed form, cheque and return label to be posted to:

Jane Harrop

4 Buckingham Road

POYNTON

Cheshire, SK12 1JH.

to clear form and start again.

To send completed form by email, click

(only use this if you are paying by PayPal)

Email address

Closing date for applications -

1st October 2009