John Cang Photography

Workshop Registration Form
(Please print out form, complete, and mail with deposit to reserve your space.)

Sign me up for South Florida Wildlife (February 18 - 25, 2006)

Workshop Fee: $1895 (single occupancy)

Enclosed is my deposit of $300.

(Please make check payable to John Cang at 3209 Heritage Point CT., San Jose, CA 95148.
Balance is due 60 days prior to departure.)

Name: _____________________________________________________

Address: ____________________________________________________

              ____________________________________________________

Phone: ____________________________

Email: ____________________________



In case of emergency please notify:

Name:_______________________________________  Relation:_________________________

Address:_______________________________________________________________________

Phone:______________________________

Smoking is not permitted in the vicinity of the group.