Registration Form for QNE 2015
PLEASE PRINT Clearly:
Please mail the registration form and your check
payable to NSQG to:
Quilt Nebraska c/o Bonnie Kucera
905 Goldenrod Circle
Hickman, NE 68372
There are four time periods to schedule: Friday AM,
Friday PM, Saturday AM, and Saturday PM. If you
choose not to attend a workshop/lecture during a
time period, please check No Class Wanted. Please
indicate your 1st, 2nd, and 3rd choice for EACH
TIME PERIOD. If you choose an all day class, please
write it as the same choice morning and afternoon.
Name_____________________________________
Address___________________________________
City, State, Zip______________________________
Home Phone (____) _________________________
Cell Phone (optional) (_____)__________________
E-mail address (Used for class confirmation)
__________________________________________
REGISTRATION CHOICES
Example—Saturday
Morning
Afternoon
___No class Wanted ___No Class Wanted
1st choice SAD01
1st Choice SAD01
2nd Choice SAM62 2nd Choice SPM74
3rd Choice SAM19
3rd Choice SPM20
All Fees & Prices are Per Person
PLEASE CIRCLE YOUR CHOICES
Full Pkg. (4 units- 4 meals) NSQG member
$230.
Full Pkg. (4 units– 4 meals) Non-member
$255.
One Day (2 units - 2 meals) NSQG member $155.
Friday
Morning
Afternoon
____No Class Wanted
____No Class Wanted
1st Choice _________
1st Choice_________
2nd Choice_________
2nd Choice_________
3rd Choice_________
3rd Choice_________
Saturday
____No Class Wanted
____No Class Wanted
1st Choice_________
1st Choice_________
2nd Choice_________
2nd Choice_________
3rd Choice_________
3rd Choice_________
Top Three Most Wanted Classes
(regardless of time slot)
_____________/______________/___________
Every effort will be made to select from your most
wanted classes. If this isn’t possible, we will try to
give you at least one of your first choices.
One Day (2 units - 2 meals) Non-member
$180.
Quilt History Day
$ 40.
Friday GUEST Banquet
(#_____x $35)
$____
Saturday GUEST Banquet (#_____x $35)
$____
Registration Total
$__________
QNE 2015 T-Shirt Order
Select your choice for QNE 2015 Gildan T-shirt:
Antique Cherry Red 90% Cotton/10% Poly
Small____ Med____ LG____ XL ______ S10.00
2X ____ 3X_____ 4X
_____5X______
Special Event Opportunities
I would like to be a teacher’s Aide. Yes____No____
Bringing challenge quilt.
Yes____No____
Bringing a Friendship Exchange
Yes____No____
Bringing a Block for Block Exchange Yes____No____
Bringing a Show ‘n Tell
Yes____No____
I am bringing a raffle quilt.
Yes____No____
(Guild name_______________________________)
Is this your first QNE?
Yes___No____
T-Shirt Total
Total Due:
Registration and T-shirt
Make check payable to NSQG
$_________
$__________
Circle if needed:
Dietary needs: Gluten Free Vegetarian
21
$12.00