Karen Combs' Class Contact

First Name *

Last Name *

Title of Organization *

Guild or Organization *

Street Address *

City *

State *

Zip *

Cell number *

Email Address *

Guild's Webpage Address

Nearest Airport (NOT needed if booking a virtual event)

Additional Contact Person (for emergencies): *

Cell number *

Email Address: *

Are you interested in a VIRTUAL lecture/workshop or an IN-PERSON lecture/workshop? *

Average Attendance at lectures/meetings, approximate: *

Regularly scheduled meeting date(s) (week, day and time) *

Please indicate the number of lectures you would like:

Lectures topic (this can be changed later, if needed)

Please indicate the number of workshops you would like:

Day(s) of week preferred for workshops: *

Workshop topic(s) (this can be changed later, if needed)

Time of Workshop

Please email me the Teaching Packet File *

Other Notes or Requests: