HPA 2012  SPRING REGIONAL SHOW AND SALE

REGISTRATION FORM

 FRIDAY, APRIL 20 and SATURDAY, APRIL 21, 2012

Beloit, Wisconson

NAME:________________________________________________

ADDRESS: ____________________________________________

CITY, STATE, ZIP__________________________________________

PHONE: _______________________________________________

E-MAIL: _____________________________________________

Number of six foot tables                                        ____ @ $10 EACH = __________

Number of Friday Night Dinners                           _______ @ $15 EACH = ________  

fish fry at Coyote's, 107 Dearborn, Beloit, Wisconsin                  

Number of Saturday night dinners 

at Larry and Jerilyn Cornellier's home                   _____ @ $15 EACH = ________

                                                                                                              TOTAL: ________

Please make check payable to  (DEADLINE MARCH 31, 2012)

HULL POTTERY ASSOCIATION

and mail to:

 Larry Cornellier

5510 Manchester Road

South Beloit, IL 61080