name _______________________________________________________________________________

business name:_______________________________________________________________________

address:_____________________________________________________________________________

city/state/zip:_________________________________________________________________________

phone day:_________________________________phone evening:______________________________

Email address_____________________________________________

Workshop date you are reserving___________________________

               Advanced Leather Workshop 3 day seminar is $795.00.

Sewing Machine Basics  1 day seminar is $250.00

All materials are included

To reserve your space, a deposit of $100.00 must be made with check or credit card.

If you pay by check, full tuition must be received 10 business days before start of workshop

If you pay by credit card, balance of full tuition will be charged to card on the Thursday prior

to the workshop

In the event you cancel your reservation less than 30 days prior to your scheduled workshop,

the $100 deposit is NOT refundable or transferable.

Reservations are accepted on a first come, first serve basis. Confirmation of your reservation will

be mailed to you and will include nearby hotel info and map.

I AGREE TO THE DEPOSIT POLICY ABOVE ________________________________________________

                                                                                       signature required

              It is suggested that you do not make travel plans until you receive your confirmation

ENCLOSE CHECK payable to: Coachtrim   

OR  fill out credit card info below

Visa or Mastercard____________________________________________________exp. date____________

3 Digit Code from back of Credit Card  _________________       Amount   $_________________________

billing address for card_____________________________________________________________________

name on card___________________________________Authorized Signature ________________________

Print this form , then mail or fax to:

Coachtrim LLC, 45A Miry Brook Road, Danbury, CT 06810

phone  203 743 6556        fax  203 743 6687

.Coachtrim's Training Seminars

REGISTRATION FORM

Print this form using your Browser print button

Then mail or fax this form using the info at bottom of page.

OR if you prefer call our office and register over the telephone