PSGW 2003 REGISTRATION FORM

NAME:                                      Mail to:  PSGW 2003
                                                     1503 E Street
STREET ADDRESS:                                      Bellingham, WA
                                                         98225-3007
CITY, STATE, ZIP / POSTAL CODE:

PHONE:

E-MAIL:

REGISTER ME FOR:
/_/ Session One:   26 July   ­  1 August
/_/ Session Two:    2 August ­  8 August
/_/ Session Three:  9 August ­ 15 August

If the session I have chosen is full, I wish to:
   /_/ be wait-listed for my session
   /_/ try for Session _______.
   /_/ be put on the shortest waiting list.
   /_/ have my deposit returned.

/_/ I haven't attended PSGW before.
/_/ Please send me a scholarship application.
/_/ I can't attend this year, but add my name
    to next year's mailing list

Comments or special needs (e.g. vegetarian): _____________________

 _________________________________________________________________

 _________________________________________________________________

DEPOSIT

_ I enclose $________ Tuition Deposit ($200 per person per session)
                                      ($500 balance due at camp)
_ I enclose $________ in addition to my
  deposit as a tax-deductible contribution. (Thanks!)

The total enclosed is $________ (U.S. funds)