Registration form
Applique by the Bay XI
with Elly Sienkiewicz, Nancy Kerns and Emily Martin
| Print, Complete and Mail to: | Mare’s
Bears Quilt Shop 528 E. Savannah Road Lewes, DE 19958 |
Name__________________________________________________________Date______________________
Address__________________________________________________________________________________
City_____________________________________________State_____________________Zip_____________
Day time Phone( )_____________________________ Evening Phone ( )_______________________
Fax number( )_________________________ Email address_____________________________________
Registration can be done by mail, fax or phone. Payment may be made by check, money order, Visa,
Master Card, Discover, or American Express. To reserve your place at Applique by the Bay XI send a
$100.00 deposit by August 1, 2010. The balance is due by October 1, 2010.
Credit Card # _____________________________________________________________
Expiration Date ________________________Vin code____________________________
(The vin code is the last three numbers on the BACK of your card. It is required to process your card.)
Signature__________________________________________________________
Cancellation Policy: Reservations must be cancelled in writing. All reservations cancelled prior to October 1, 2010
incur a $25.00 charge. Cancellations cannot be accepted after October 1, 2010 due to teacher and housing contracts.
If unable to attend, you may transfer your registration to another person. There is a $25.00 processing/transfer fee
payable to Mare's Bears Quilt Shop.
Classes:
Day 1 (check one) Fees (check one)
Elly: Divine Guidance ______
Day 2 (check one) Day 1 or Day 2 only ($155.00) ______
Nancy: Dimensional Flowers ______
Emily: Owl on Branch ______ Day 3, 4 and 5 only ($300.00) ______
Shopping Spree w/Lunch ______
Day 3, 4 and 5 (check one) Day 1 or 2 and Day 3,4,5 ($440.00) ______
Elly: Tropical Bird in Rose Bush ______
Nancy: Mary Simon Block 3D ______ All 5 days ($580.00) ______
Emily: Lyre with Eagle ______
Shopping Spree w/Lunch ($20.00) ______
Lodging is available at the newly remodeled Beacon Motel (the building in which we are located, as well as classrooms and meals, within easy walking distance to town and beach). Rates are: Five nights @$475.00, four nights @$375.00 or $105.00 per night, per room. (Rates are subject to change and will not be charged to your card until you check in.)
Check which nights and desired occupancy: 11/30_____ 12/1_____ 12/2 _____ 12/3 _____ 12/4______
Single______Double_______Roommate's name_______________________________________________
Keep a copy of this form for your records. Supply lists will be mailed upon receipt of your deposit.
Mail or fax (302-644-3868) completed application to: Mare's Bears Quilt Shop, 528 E. Savannah Rd, Lewes, DE 19958.
Questions? Call 302-644-0556 or email: maresbears@ce.net