"Success as an Artist"
REGISTRATION FORM

The next seminar will be held on Sunday, March 26, 2006 in partnership with The Arts and Humanities Council of Montgomery County and will be held at the Round House Theatre Education Center located at 925 Wayne Avenue, Silver Spring, MD from 10:30AM - 6PM.

Please PRINT this form, complete all parts, sign it and mail it to (or fax with credit card information to 301-565-3809):

Arts and Humanities Council of Montgomery County (AHCMC)
801 Ellsworth Drive
Silver Spring, MD 20910
301-565-3805

The seminar will start promptly at 10:30 AM. The March 26, 2006 seminar will be held at the Round House Theatre Education Center located at 925 Wayne Avenue, Silver Spring, MD.

 

  • Street Address:___________________________________________________________________

 

  • City, State and Zip Code:___________________________________________________________

 

  • Telephone:_______________________Email:______________________________________

 

  • Registration Fee ($50). Seating is limited to 50 persons per seminar and will be assigned on a first come, first served basis. Please select your payment method:

* Check enclosed payable to AHCMC

* Credit Card (complete information below)

Name on card:________________________________________________
Billing address (if different from above):_____________________________
City, State and Zip:____________________________________________
Phone number of cardholder (if different from above):_________________
Type of card: [ ] Visa . [ ] MasterCard . Exp. Date:__________________
Card number:____________________________________________________

Signature: _____________________________________________

By my signature I agree to the terms and conditions as stated in the prospectus form for this seminar.