Workshop Registration

Complete this form to register for a workshop.
Please complete a separate form for each workshop that you wish to attend.

Name *

First Name

Last *

Last Name

Address *

Address

City

State/Province

Zip/Postal

Country

Email *

Please enter your email address

Phone Number

Type Number including area code, without any spaces: 0712345678

Mobile *

Type all numbers without spaces: 0421345678

Membership Number *

Medical Conditions

Do you suffer from anything we need to know about in the event of an emergency?

Single Line Text *

Emergency Contact *

Phone Number *

Workshops - Pay in Full

Please choose the workshop you wish to attend

Workshop Options *

Workshop 0120: Modern Bias Applique Techniques with Kat Jones - $130

Workshop 0220: No Pins Curves and Improvised Curves with Jenny Haynes - $130

Workshop 0320: Fearless Free Motion Quilting with Pam Hill - $130

Workshop 0420: Double Wedding Ring with Pam Hill

Workshop 0520: Mixed Technique Design Class with Neroli Henderson - $195

Workshop 0620: Tea & Ephemera with Judy Coates Perez - $130

Workshop 0720: Pele Mele Quilt with Veronique Diligent - $130

Workshop 0820: Creative Canvases Birds and Foliage Crazy Kookaburras with Sue Duffy - $130

I am paying a deposit

Payment Amount - Full Payment $

Workshops - $50 Deposit Only

Please choose the workshop you wish to attend. You are required to arrange the remainder of your payment with the Workshop Coordinator one month prior to the workshop.

Workshop Options *

Workshop 0120: Modern Bias Applique Techniques with Kat Jones - $50

Workshop 0220: No Pins Curves and Improvised Curves with Jenny Haynes - $50

Workshop 0320: Fearless Free Motion Quilting with Pam Hill - $50

Workshop 0420: Double Wedding Ring with Pam Hill

Workshop 0520: Mixed Technique Design Class with Neroli Henderson - $50

Workshop 0620: Tea & Ephemera with Judy Coates Perez - $50

Workshop 0720: Pele Mele Quilt with Veronique Diligent - $50

Workshop 0820: Creative Canvases Birds and Foliage Crazy Kookaburras with Sue Duffy - $50

I am paying in Full

Payment Amount - Deposit Only $

Notes

Deposit of $50 is required to confirm your place. Full payment is required one month prior to the commencement of the workshop. Workshops may be cancelled if there are insufficient numbers to fill a class, or due to illness or incapacity of the tutor. Full refunds will be given if any workshops need to be cancelled. If you are unable to attend a workshop, please let the Workshop Convenor know as soon as possible. Please contact Olive Claydon, our Workshop Convenor on 0408 988 946 or by email, [email protected], if you have any questions.

Payment Method

You can make payment by Direct Deposit to Queensland Quilters OR by Credit Card

Direct Debit

Name of Account: Queensland Quilters Inc BSB: 034-002 Account Number: 768617 Please include your last name and membership number as the payment reference.

Credit Card

Please contact Verna Hunt with your credit card details. Phone: 32888925 Mobile: 0409 062 485(Click to add description)

Section

Signature *

Clear

Date *