Enrollment Form

Enrollment Form

Please fax or mail this form with payment to:

Stacy Bear, Manager Educational Programs
GemStone Press, P.O. Box 237, Woodstock, VT 05091
Phone 802-457-4000 ; Fax: 802-457-4004

The Antoinette Matlins Practical Gem and Jewelry Course
for Jewelry Lovers, Collectors and Connoisseurs

Name (Print): ________________________________________________

Street Address: _______________________________________________

City, State, Zip: _______________________________________________

Tel: __________________________ Fax: __________________________

E-mail: ____________________________________

Please enroll ________ people @ $585.00 each = $ ______________

Method of Payment

____ Check enclosed for $ ___________ payable to: GemStone Press

____ Credit Card: ___ Visa ___ Mastercard

Name on Card: ________________________________________________

Credit Card #: _____________________________ Exp. Date: __________

Signature _____________________________________________________

Billing address if different from above:

______________________________________________________________

Travel expenses and accommodations are the responsibility of participants.