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Business Registration Form for Workshops

*	Indicates required field

*	Name:
	Other Attendee Names:

	BUSINESS CONTACT INFORMATION
*	Company/Organization Name:
*	Address:
*	City, State, Zip:	,
*	Phone:
	Alt Phone:
	Fax:
*	Email:

	WORKSHOP SELECTION
*	Workshop Name:
*	Date:
*	Time:
	Cost (if not free):

	Number of people attending:
	Amount being paid:

	PAYMENT Mail payment prior to the workshop or make payment on the day of event. Payment by cash or check only (no credit cards accepted). Make checks payable to “Rochester Works, Inc.”

	How did you hear about this workshop
		Newspaper Friend Flyer RochesterWorks website Other