Workshop Pre-Registration Form

Social Graces, Etiquette & Leadership Workshop
(for Boys & Girls Ages 9 to 13)
Date: Saturday, May 3, 2008
Time: 8:00 a.m. to 1:00 p.m.
Location: Golfcrest Country Club
2509 Country Club Drive
Pearland, TX 77581

Cost: $65.00 per person

To register, please fill out the form below and print it before submitting. Mail the printed copy of this form with your check for $65.00 to:

First Impression Image Consulting
P.O. Box 84132
Pearland, TX 77584

You will receive a temporary registration confirmation via email.

*Indicates a required field


Workshop Date:

*Participant Name:

*Address:

*City:

*State:

*Zip Code:

*Phone Number:

*Age:

*Parent's Name:

*Home Phone Number:

Cell/Pager Number:

*Email Address:

*Confirm Email Address:

*Emergency Point of Contact other than Parent:

Additional Comments:

* Indicates Required Fields

Remember to Print This Page before you submit!


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