REGISTRATION FORM FOR THE WINNERS! WORKSHOP

APRIL 25-27, 2012

Please make a copy of this registration form (CTL P or right click Print), fill it out, and mail it to us with your check for $179.00 (payable to Judy Freeman’s Workshops LLC) or mail or fax it with your P.O. to the address below.

YOUR REGISTRATION FEE OF $179.00 INCLUDES: continental breakfast, lunch, a fabulous conference handbook, and certificate of participation (with 5 professional development contact hours).  Check-in is from 8-8:30 a.m. Program hours are 8:30am-3:15 p.m. CLICK HERE FOR DIRECTIONS TO ALL THREE VENUES.

SEND TO: JUDY FREEMAN'S WINNERS! WORKSHOPS
c/o Peggy Beck Haines
107 S. Forklanding Road
Maple Shade , NJ 08052-2747
Home: 856-779-7357 Cell: 856-296-0193 Fax: 856-667-7470

 if unavailable, fax 732-985-5810
E-mail: JudyFreemansWorkshops@gmail.com   Website: www.JudyReadsBooks.com
PLEASE FILL IN THIS FORM IN YOUR VERY BEST PRINTING! 
YOUR NAME
School Library Media Specialist: Grades
Public Librarian
Classroom Teacher: Grade(s)  
Special Area Teacher: Job Title/Grades
Other (Job Title/Grades):
Library or School
Work address
City, State, Zip code
Work phone
Work email
Home address
City, State, Zip code
Home phone
Home email  
(NOTE: If you use a school e-mail address, our e-mails to you could end up in your spam folder. If you find it in your spam folder, click "not spam" and save as new. If this is a problem in your school or library, please add us to your contact list and/or address book.)

I AM REGISTERING FOR (CHECK ONE):
  ___ WINNERS! Voorhees, NJ, Wed., Apr. 25, 2012        $179.00
  ___ WINNERS! Edison, NJ, Thurs., Apr. 26, 2012 $179.00
  ___ WINNERS! Whippany, NJ, Fri., Apr. 27, 2012               $179.00
    Total Payment                                                                                       $

PAYMENT METHOD:
1. Check enclosed, payable to Judy Freeman's Workshops, LLC
2. Purchase Order and Check enclosed, payable to Judy Freeman's Workshops, LLC
PO number:
School, Business, Office Address:

PO Contact Person & Phone number:
SUBSTITUTIONS & CANCELLATIONS Substitutions are allowed at any time—just let us know. If you cancel up to one week prior to the date of the workshop, you are entitled to a full refund. If you cancel within one week or less prior to the workshop date, there will be a $10.00 cancellation fee to handle expenses. (Please note: If you must cancel at the last minute, we may need to deduct the cost of the food and other processing charges from your registration, depending on the venue.)

PLEASE MAKE COPIES OF THIS FORM FOR YOUR COLLEAGUES.