KILLER INSTINCTS WORKSHOP
ONLINE REGISTRATION FORM
Please complete all blanks prior to submitting.

KillerInstincts for (month) (title)

Check one: 

   A current member of KOD?    Yes       No

Name (please print if mailing)

Phone

Email address

Payment sent through PayPal.

Signature (if mailing)

PLEASE NOTE:
you will receive an INVITATION to join the
group from yahoo!groups and you MUST reply to it in order
to take the course.

I understand that admission to the workshop depends on RECEIPT OF THIS FORM AND PAYMENT BY THE STATED DEADLINE for the workshop chosen. If the payment is received after the payment deadline, the fee will be applied to a future workshop of my choosing.

NOTE:
**PAYMENT MUST BE RECEIVED BY THE 27TH OF THE MONTH PRIOR to
the start of COFFIN class,
i.e. beginning COFFIN workshop date January 1, payment must be received by December 27.**