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WORKSHOP
REGISTRATION & DINNER PACKAGE RESERVATION FORM
Please Print:
Name________________________________________________________________________
Street
Address_________________________________________________________________
City, State,
Zip_________________________________________________________________
Area Code
____________________Phone___________________________________________
e-mail address
_________________________________________________________________
Workshop Class First Choice
No.____________
$_______________
No.____________
$________________
Workshop Class Second Choice
No.____________
$________________
No.____________
$________________
Class #8 (Circle
Choice)
Floral
Shop
Ice Cream Parlor
Friday Dinner/Silent Auction (includes admission
to sales room both days)
Circle Choice
of Entree: Chicken
Pork
If you have special dietary needs, please
call Linda Gearhart (636) 296-2079 or (314) 566-5645 or email llgear@sbcglobal.net
Dinner Fee for Member
$30.00 $________________
Dinner Fee for Non-Member
$32.00
$________________
Museum Membership: See Fee Schedule Below
$________________
Total
$______________
If you want to sit with a particular person at DINNER,
please include name below:
__________________________________________________________________________________
Sorry, No Smoking in Dining Room
DINNER RESERVATIONS MUST BE RECEIVED BY
APRIL 6, 2012
NO REFUNDS AFTER APRIL 6, 2012
To help defray Museum expenses, please include a self-addressed
stamped envelope (SASE) with check payable to:
Miniature Museum of
Greater St. Louis
Send payment, Self Addressed Stamped
Envelope, and this form to:
Linda Gearhart, 3190
Rosedale Dr., Arnold, MO 63010
Phone: (636)
296-2079 or (314) 566-5645
e-mail: llgear@sbcglobal.net
* * * * * * * * * *
Annual Membership
levels (circle one)
- Students $10 (under 18 years ) -
Benefits shown on Membership
page
- Individual $15 - Benefits shown on Membership
page
- Family OR Grandparents $25 -
Individual benefits plus free admission for parents and children under
18; OR grandparents and children under 18
- Supporting $50 - Individual
benefits plus free admission for 2 guests
- Sustaining $100 - Individual
benefits plus free admission for 4 guests
- Benefactor $500 - Individual
benefits plus free admission for 4 guests, and 2 tickets to Gateway
Miniature Fair Show & Sale
* * * * * * * * * *
Return
to the April 2012 Classes
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