SCRAP Bin
Visit us on the Web at www.scrapbin.org
Workshop Registration Form
Workshop Title: _____________________________
Name:
Date: ______________ Session: ______________
Date:
Mailing Address:
Street Address:
City:
State:
E-mail:
Phone:
Zip:
Payment at this time is by check or cash. Please make your check payable to SCRAP Bin and include
payment with this form. You may drop off payment and form at SCRAP Bin or mail it to:
SCRAP Bin · 105 Folds Drive, Suite 3 · Carrollton, GA 30117
Form and amount of payment received:
Cash
Check # _______
Amount: __________
Photos will be taken for use on the SCRAP Bin website and other public relations materials unless the responsible party indicates otherwise.
form as of September 22, 2010