| JANUARY JUMPSTART XII Marianne Worthington, Poetry Leader Cary Holladay , Fiction Leader January 13-15, 2012 |
||
| Registration Deadline is January 6, 2012 | ||
| REGISTRATION FORM |
||
| Name: | ____________________________________________________ | |
| Mailing Address: | ____________________________________________________ | |
| City/State/Zip: | ____________________________________________________ | |
| Phone: | ____________________________________________________ | |
| Email: | ____________________________________________________ | |
| Please circle the items for which you are paying. |
||
| Please mark the workshop you wish to attend: Poetry: ______ Fiction: ______ |
Workshop TMW and TWA Members: Non Members: Optional TWA Membership: TMWI Membership |
.....$100 .....$110 (workshop and membership) .......$30.00 .......$10.00 |
| Amount Enclosed |
$ _________________ |
|
| Mail to: | TMW/January Jumpstart 2012 P. O. Box 5435 Oak Ridge, TN 37831-5435 |
|
| For additional information contact Sue Richardson Orr at theorrs@usit.net | ||