Licensing EXPRESS Registration for The Perfect Mix

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REGISTRATION FORM

Licensing EXPRESS: The Perfect Mix

August 15-18, 2021

Irving Convention Center

500 W Las Colinas Blvd | Irving, TX 75039

Directions:
1) An asterisk * means a field is required.
2) Cost is $1,699 and we will contact you to confirm your registration and send you a payment link. Check, Visa, MasterCard, American Express and Discover payments are accepted.
3) Upon completion of this form you will receive an email copy of your registration.
4) One half of a double room is included in the cost. An additional $400 surcharge applies for private hotel accommodations. If you want a private room, note that below in your registration.
5) Welcome reception, lunch each day, and a closing dinner are provided.

6) Licensing Express students pay only $10/session (plus any material fees) for Original Sewing & Quilt Expo classes on Thursday, Friday & Saturday. (Call 800-699-6309 to place your Expo order and apply this special discount. Expo classes will be open for registration in June.)

Email your questions to angela.jones@hoffmanmedia.com or call 256-655-3090

*First Name:

*Last Name:

*Mailing Address:

Address 2:

*City:

*State, Province or Region:

*ZIP Postal Code:

*Country:

Please enter a daytime telephone number.

*Primary Telephone:

Mobile Phone:

*Email:

*Verify Email:

*Emergency Contact:

*Emergency Phone Number:

Background Info

How did you hear about the Licensing Program?:

How many Liscensing Programs have you attended?

How many Martha Pullen Licensing Programs have you attended?:

Please enter a value for the field Comments.

Which machine brands and models do you own:

Details

Name as it should appear on frameable Certificate of Achievement:

Hotel Accommodations

Registration fee includes 4 night hotel stay at The Westin (shared with a roommate, or pay an extra $400 for a private room). Check-in on Sunday, August 15, Check-out Thursday, August 19 (add-on nights at $195 each).

Hotel Room Arrangement:

Additional Hotel Nights Needed:

Additional days are $195 per night, including tax. Extra nights will be a private room. Please list the numerical dates of any added nights in the Comments section below.

Please enter a value for the field Name on Credit Card.

Prefered Roommate or Friend's Name (if applicable):

Comments and Special Instructions (any info is helpful):

Food Allergies or Special Meal Requirements:

Payment Process

Our staff will contact you by telephone to complete

Good time to call & additional comments:

Order Confirmation

Please select "Yes" to agree to Terms and Conditions.

All cancellations must be received in writing by July 18, 2019. A cancellation fee of $400 will be withheld from any refund.

After you click "Submit Registration", if you are NOT transferred to the Thank you screen, please scroll up to see which fields need attention.

Thank you to these fine companies who provide continued support.