CREATIVE WRITING WORKSHOP REGISTRATION

Name ________________________________________________________

Address ______________________________________________________

City ________________________State ______ Zip ___________________

Phone ____________________  Email address _______________________

Please use the space below to briefly describe your writing interests and experience

____________________________________________________________

____________________________________________________________

____________________________________________________________

To register print out form, complete, and mail to

George Dila

310 N. Ferry St.

Ludington, MI 49431

with a check payable to George Dila for $50

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