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REGISTRATION FORM

Name (for name tag): ________________________________

Address: _________________________________________

City: __________________ State: ________ ZIP: _________

Phone: _________________________________

Email: __________________________________

Payment Method:

• Check (Make payable to Nicolaysen Art Museum and mail with registration form. Click HERE to print registration form)
• Online (PayPal or major credit card*)

MEMBERS Name & Address Phone & Email

NON-MEMBERS Name & Address Phone & Email

STUDENTS Name & Address Phone & Email

DAILY RATE Please indicate day attending August 5 August 6 Name & Address Phone & Email

*Registration form above should still be completed and sent to:
Nicolaysen Art Museum
400 E. Collins Dr.
Casper, WY 82601