Request for Information


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Request for Information

First Name:
Last Name:
Organization:
The following address is: My home address
The organization's address
Address:
City:
State:
Zip/Postal Code
Email:
Phone:
I would like:
(check as many as apply)		 To be added to Diane's mail list. (please include your postal address above)
To be added to Diane's e-mail list. (please include your email address above)
To receive a package of information. (please include your postal address above)
I am interested in:
(check as many as apply)		 Performances:
Storytelling Concerts for Adults
Children/Family
Workshops:
Beginning or advanced storytelling skills
Nature/Environmental storytelling workshop
Residencies for schools
Other questions and comments: