LOCATION: St. Mark’s Lutheran Church, 2300 Washington, Evansville 47714
This hands-on keyboard adventure is open to the first 20 applicants.
REGISTRATION FEE: $10.00 which includes all materials plus lunch.
REGISTRATION DEADLINE: Friday, February 17, 2006.
QUESTIONS? Please contact Helen S. Reed, 812-476-0673, hsr@evansville.net.
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(You may copy and past the form below into your word processor for
printing)
YES, sign me up for PEDALS, PIPES, AND PIZZA , FEBRUARY 20, 2006!
Please complete this form and mail it by February 17, 2006 to:
Helen S. Reed, Education Convener, 1435 Brookside Dr., Evansville IN
47714
Please enclose a check or money order for $10, payable to Evansville Chapter A.G.O.
Name: _______________________________________________________________________
Address: _____________________________________________________________________
City: __________________________ State/Zip: ________________Phone: ______________
Date of Birth: _______________ School: _____________________________ Grade: ______
I have taken piano lessons for ___________ years.
I have special dietary requirements: ________________________________________________
This student (if under age 18) participates in PEDALS, PIPES, AND PIZZA with my permission.
Signature of Parent or Guardian:___________________________________________________