Mexico City Canine Natural History Exploration, February 16

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REGISTRATION FORM

MEXICO CITY CANINE NATURAL HISTORY EXPLORATION
Dr. Ray Coppinger
Monday February 16 to Friday February 20, 2009

First Name:
Last Name:
Business/Organization:
Address:
City:
State/Province:
Zip/Postal:
Work Phone:
Home Phone:
Email:
Method of Payment: Visa Mastercard Check in the Mail
Account Number
Expiration Date
Validation Code	last 3 digits on signature panel.

*WORKSHOP FEES*
Monday February 16 to Friday February 20, 2009
PROGRAM IS FULL: Please e-mail us at: events@puppyworks.com with your name and telephone #, use the subject line : "Mexico City wait list".
	Workshop Balance	$1,700.00
*And don't forget...*
	Please send me more brochures to share with friends and colleagues.
	Notes/Special Requests:

An email confirmation will be sent to you for your files.

Please complete this registration form and mail in a check or provide us with your credit card number above. You can also phone or fax us your registration and payment information.
Please make checks payable to:

Petworkshops, LLC / Puppyworks
PO Box 938
New Paltz, NY 12561

email: events@petworkshops.com
phone: (917) 699-6440
fax: (845) 255-4920

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