Final date to register for seminars is: Monday June 15, 2002

Presenters legal name:________________________________________
Presenters Magical name:______________________________________
Address:______________________________________________________
City/State:__________________________________Zip code:_________
Phone number:___________________Email:__________________________
Site URL:_______________________________________________________
Please describe the type of workshop or seminar you want to offer at our event:

Do you have any Special Requirements (table surface, seating?):

Please provide a bit of your background and qualification for presenting this seminar or workshop:

Biographical sketch for our program book (60 words or less):

Please include a short description of your workshop or seminar for our program book (90 words or less):

Please select the category that best applies:
Lecture and discussion ___ Arts and craft ____ Ritual ____
Music and movement ____ Performance ____ Children/family _____
Choose the interest level that best applies:
Beginner ____ Intermediate ____ Advanced ____ Elders ____
Children ____ Young adult ____ Families ____
Someone from our Workshop/Seminar selection committee may phone you to follow up on information or to ask further questions. They will identify themselves as members of the PPD Planning Committee. Please do not hesitate to contact me (Lorri 937-444-0235) if you have any questions or concerns.

"I hereby state that I have read, understand, and agree to comply with the terms of this seminar or workshop presentation agreement."

Seminar Name: __________________________________________________________

Legal name:________________________________________Date:_________________