Summer Workshop Registration Form  2009

check one:

            Youth Workshop  July 13-17

            Adult Workshop   July 27-31

Name:__________________________________________________________

Address:_________________________________________________________

Home Phone:_____________________________________________________

Cell:____________________________________________________________

Comments to the Director (optional):

Cost:  $50.00 per student

Please make checks payable to The Alliance for the Arts, Ltd.

Mail to: The Alliance for the Arts, Ltd.

            c/o Cameron Burton

            500 Bland St.

            Bluefield, WV  24701