JASNA Massachusetts

Jane Austen Birthday Celebration at WGBH Studios Registration Form

Please reserve ______ spaces at $20 per person = Total enclosed $______________

Deadline: December 3, 2007

Name ____________________________________________________________________

Address___________________________________________________________________

City, State, Zip______________________________________________________________ 

Phone_____________________________   (in case we have questions about your registration)  

Email Address ______________________________________________________________

Mail completed registration form and check payable to JASNA Massachusetts to:  

Heidi Sondergaard Jensen
Treasurer, JASNA Massachusetts
32 Dalton Road
Holliston, MA 01746-2417