Celebrating the State of Craft

Registration Form

Please print this form, write in the requested information, and mail it to the address below the form.

Name

Address

City

State Zip
Daytime Telephone

Evening Telephone

Fax

Email

I am a current Florida Craftsmen member
 Yes  No
New FC members or those wishing to renew at this time may enclose annual dues and beneifit from reduced Conference fees. Dues are effective for one year from the date received. (Reduced conference fees also extend to members of the DeLand Museum of Art.
 $25 Student (must include copy of current student I.D.)
 $35 Artist Member
 $40 General Member
 $65 Family
  Annual FC Dues Enclosed: 
I am a current DeLand Museum of Art Member:
 Yes  No

Workshops I'd Like:

Please list workshops for which you are registering:

Friday Workshop
Workshop

Instructor

Saturday Workshop
Workshop

Instructor

Sunday Workshop
Workshop

Instructor

 I need additional information on local hotel/motel accommodations.

Register me for:

FC/DMA Member Non-member Student
 Full Conference Weekend $265 $290 $200
 Two-day Conference Fee $185 $210 $150
 One-day Conference Fee $85 $100 $70
 One-day "Floating Fee" $50 $60  --- 
Saturday Night Keynote, Slides & Dinner Party
*Extra fee for one-day & floater registration
# of people: @ $25 each =
 Late Registration fee
After March 12, 2003
$25 $25 $25
Total Amount Enclosed:

Payment Method:

 Check/Money Order Enclosed  (Make payable to Florida Craftsmen, Inc.)
Charge My Credit Card  Visa  Mastercard 
Name on card

Card number

Expires Month:  Year: 

Signature __________________________________________________

Mail form with payment to:

FC Regional Conference
c/o Florida Craftsmen, Inc.
501 Central Avenue
St. Petersburg, Florida 33701
Please duplicate this form if necessary.