Workshop with Barry Moses - April 23
Sign in to Google to save your progress. Learn more
First Name *
Last Name *
Email *
Phone
Address (Street) *
Address (City/Town) *
Address (State) *
Address Zip *
Would you like to make a snack donation?
Please bring your own lunch.  We'll provide a snacks table throughout the day, and we welcome any snack contributions you feel moved to make!  Easy-to-eat / finger foods preferred.  
Proceeds will go to covering event costs and Barry's travel.  Any remaining funds will be donated to the charity of his choice.  
Amount I am paying today:
Requested donation is on a sliding scale $30-100.  No one will be turned away for lack of funds. Your donation is tax-deductible.
I will be paying today via:  
I would like to volunteer to support this event.
Arrive early to help set up, and stay after to clean up.  You'll still get to attend, but you may miss a small part of the workshop.  Volunteers help set up chairs, staff the table at the door, etc.  An event organizer will contact you in advance.
Questions or comments
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.