Wufoo

susan stripling | workshop registration form

which dates are you registering for? * july 9 - 10, 2008 (california) sept. 30 - oct. 1, 2008 (colorado)
your name * First Last
phone number * - (###) - ### ####
email address
business name
website
billing address *

Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
name on credit card
credit card number
security code / MM / DD YYYY
expiration date
what do you hope to learn/take away from this workshop?
thank you!

if you have any questions please email us at susan@susanstripling.com or call the studio at 850.224.9992. your card will be charged today for $600 and the remaining $600 will be charged one month before the workshop date. monies paid are not refundable but may be sold or transferred to another photographer or attendee.

filling out this form and submitting it gives susan stripling photography permission to charge your credit card on the above dates/times and confirms your workshop registration.
Do Not Fill This Out