Announcements     Dustin Tabor Class Info     Dustin Tabor Bio

 

The Southern Flames present  DUSTIN TABOR Lottery Form

 Name:                                                                                                              

Address:                                                                                                          

                                                                                                                       

Telephone:                                                                                                       

Alternate Telephone (mobile):                                                                           

Email Address:                                                                                                 

 

Dustin Tabor Class Preference (only check one):

 

              Only able to attend September 13 & 14 (Thursday/Friday)

 

              Only able to attend September 15 & 16 (Saturday/Sunday)

 

              Can attend either session, prefer Thursday/Friday -You may be placed in either class.

 

              Can attend either session, prefer Saturday/Sunday – You may be placed in either class.

 

                    Do you want to be on the waiting list if your name is not drawn for a class session (circle one)?  yes    no

 

Please print out and complete this form.  You can either drop this form and your check off at the July 18, 2007 Southern Flames meeting, or you can mail the completed form and your check in the amount of $260.00 made payable to “Southern Flames” to:

Southern Flames

311 Peachtree Hills Avenue, Box 11A

Atlanta, GA  30305

NOTE:  Mailed CHECKS AND FORMS MUST BE RECEIVED BY KIM RUNGE by Tues July 17, 2007

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For Southern Flames Administrative Use Only

Received On _________   Check # __________

 

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Announcements     Dustin Tabor Class Info     Dustin Tabor Bio