Register for the Group Pattern Language Project's Seattle, Washington Workshop, Sat. March 28th, 2015

(fields marked * are required)

Who Are You?
Name *
Organization
Home Phone
Mobile Phone
Email *
Geo Location
City *
State/Province *
ZIP/Postal Code *
Dietary Needs

Diet

 Omnivore
 Vegetarian + Fish
 Vegetarian
 Vegan

Allergies

 No Dairy
 No Gluten/Wheat
 No Peanuts
 No Soy
Other Allergies/Comments

We’ll do our best to accommodate you.

Staying in Touch
Add me as a user on groupworksdeck.org, so I can access and edit materials and join the online community:
 yes

Add me to the email list "pattern-hi" for Group Works online discussions:
 yes

Add me to the email list "pattern-lo" for very occasional announcements of project activities:
 yes
We'd Like to Know
How did you hear about us?
What are you hoping to gain from this workshop?
Payment

We use a sliding scale fee to keep this event as accessible as possible. Please talk to us if the amounts listed here aren’t a fit for you. We encourage you to offer what you can, in support of this nonprofit project which has been created by a volunteer collective as a labor of love and service.

Sliding Scale Registration, $40 - $200: $ *
Payment method:
PayPal
paper check
*

Comments, Questions, Concerns
Anything else you
want to tell us?

If you don't wish to use PayPal, please make your check payable to “Group Pattern Language Project” and mail to:

Group Pattern Language Project,
201 Galer St, #424, Seattle WA 98109
(If the name on this form doesn't match the printed name on the check, be sure to write the name that's on this form onto the check.)

A confirmation message will be emailed to you along with any final details.

Questions? Comments or issues with this form? Please contact Dave Pollard: dave.pollard@gmail.com