jeregister

Miami's specialist cross-stitch shop!

Class Registration Form

Please complete this form and mail it to
The Cross Stitch Station, Inc., 1365 NW 98th Court, City of Doral, FL 33172.

Class Number: CL          /               Class Date (M/D/Y) :      /     /
Class Name:

Name:
Address 1:
Address 2:
City:                                                 Zip:

Home Tel:                                          Bus. Tel:
email:

Would you like to receive our newsletter by email?    Yes: [    ]     No: [    ]

The above details will be used only in connection with business and promotions of The Cross Stitch
Station, Inc., Miami, FL.

Payment Method:   check [   ] credit card [   ] cash (in shop only) [   ]
   Credit card payments: Visa [   ]   Mastercard [   ]
   Card Number:                                                  Exp. Date:      /
   Name on Card:
   Signature:

Please send this completed form to:
The Cross Stitch Station, Inc., 1365 NW 98th Court. City of Doral, FL 33172

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