Please complete this form and mail it to
The Cross Stitch Station, Inc., P.O. Box 310457, Miami, FL 33231.
Class Number: CL / Class Date (M/D/Y) : / / 2003
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., P.O.Box 310457, Miami, FL 33231.