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Class Registration
Name: ____________________________________________________________
Address: __________________________________________________________
City/State/Zip: ______________________________________________________
Phone Number: _____________________________________________________
Email: ____________________________________________________________
Class: ____________________________________________________________
Dates: (must be pre-arranged with Purple
Fleece) ____________________________
Due to the nature of private instruction,
a non-refundable $25.00 deposit is required
with this registration form.
Please make checks payable to Deborah
Bergman and mail to:
Purple Fleece
103 School Street
Stockton Springs, ME 04981
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