The EduCulture Project at

Teaching and Learning From Farm to Table
Introductory Workshops on Edible Education

Registration Form

Please PRINT, complete, and return this form with check or payment information to:
Global Source Education, PO Box 11316, Bainbridge Island, WA 98110

You can register by phone during office hours at 206-780-5797

Return to Global Source Home

	Teaching and Learning from Farm to Table Two Summer Workshops
Tuition $95 $85 for GSE members	Workshop I: July 20, 2011, 10:30am-7:30pm Workshop II: August 17, 2011, 10:30am-7:30pm
$35 $_______	Global Source Membership/Contribution Other Tax Deductible Contribution to Support the EduCulture Project
$_______	Total Amount Due
Applicant's Name
Summer Mailing Address
Summertime Phone #
E-Mail
School/Organization/Farm

Grade Level, Position

Notes

Pay by check made to: Global Source Education (preferred)
Pay by Credit Card (Visa or MasterCard accepted)
Credit Card Information    MasterCard     Visa    Exp Date ____/____
Credit Card Number    __ __ __ __ - __ __ __ __ - __ __ __ __ - __ __ __ __

Date of Registration________________

Applicant Signature (required for registration) ________________________________