Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

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Are you CPR Certified? *

Yes

No

are you interested in assisting with the procurement of goody bag and door prize donations. We are looking for an immediate volunteer(s) *

Yes

No

interested in teaching a class at retreat. Classes are typically 90 minutes long and can range in skill level and technique. Classes related to, but not specifically involving beading are very welcome! *

Yes

No