Name

Address

City

  State   Zip

Home Phone

  Work Phone

eMail

  fax

Workshop

   Date

 

Cost $ + Materials $ = Total $
     - $ Deposit = $  Balance Due

Workshop

   Date

 

Cost $ + Materials $ = Total $
     - $ Deposit = $  Balance Due


Visa   Mastercard   American Express   Personal Check  

Name on Card

Card Number

  Expiration Date  /

 

Print out this page, fill in the form and mail with your payment payable to: Vision Quest. Deposit required for workshop registration. Questions or late registration, call Beasley Photography, 651-644-1400. Mail registration form and deposit to: Beasley Photography, 2370 Hendon Avenue, St. Paul, MN 55108-1453. (You can also fax this form with your credit card information to 651-644-2122.) Directions to retreat center and list of what to bring will be sent following receipt of deposit. A portion of proceeds goes towards environmental preservation. Thank you for supporting Vision Quest.

If you are comfortable sending credit card information via eMail, you can submit this form... if you are not comfortable sending credit card information via eMail, you can type "call me at " and your phone number in the card number field. Thanks.




All photographs on this website are copyright © Doug Beasley, et al.
and may not be reproduced without the permission.
Most photographs are available for purchase : Contact Doug Beasley at 651-644-1400

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