Copy and print this form and Mail with your check
payable to Stony Mountain Fibers
or credit card information.
CLASS/WORKSHOP REGISTRATION FORM
Stony Mountain Fibers
939 Hammocks Gap Road
Charlottesville, VA 22911
Name:__________________________________________________
Address:_______________________________________________
City:__________________________________________________
State:__________ Zip:____________________________
Phone: (______)_______________________________________
E-mail:________________________________________________
Register me for the following class(s):
Title of Class/Workshop:
_______________________________________________________
Dates of Class:
_______________________________________________________
Title of Class/Workshop:
_______________________________________________________
Dates of Class:
_______________________________________________________
Payment:
A check is enclosed in the amount of:$_________________
OR please charge my account:
MasterCard_____ Visa_____ Discover_____
Account #______________________________________________
Expiration Date:_______________________________________
Signature:_____________________________________________
Thank You
