Please print and mail this form, with payment by check (made payable to Michiana Writers' Center) to:
Michiana Writers' Center
c/o Kathy Higgs-Coulthard, Director
33499 Old Post Road
Niles, MI 49120
| Name of person attending class: |
| If under 18, parent name: |
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e-mail: |
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Home Address: |
| phone: |
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Class title & Dates: |
| Amount of payment: |
| Check #: |
| How did you hear about this class? |