Workshop Registration Form

Talleres de Mujeres Registration

Complete form below to signup for the workshop.
Name

First NameLast Name
E-mail
example@example.com
Phone Number
DOB
Ethnicity/Race
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact
Phone Number
Any Diet Restrictions
Which workshop would you like to attend for 2023?

Winter - December 2
Workshop Donation

prevnext( X )
USDDescription
Pay with PayPal

Fastlane Checkout

Choose from one of the PayPal options to make your payment.

Contact Info

Payment Info
Should be Empty:

Talleres de Mujeres Registration