Application

North Platte Wood Carvers Club

Name (s)_______________________________________________________________________

Street Address___________________________________________________________________

City ______________________________________ State ______________ Zip ______________

Telephone _________________________________ E-Mail ______________________________

All names MUST be registered to participate in competition.

I plan to enter carvings in the following category #’s:

______________________________________________________________________________

I/We certify that all carvings to be exhibited by me/us are hand carved and are my/our own work. I/We

Certify that the Quality Inn & Suites, the North Platte Wood Carvers Club, its officers and members will not be responsible for

any loss, damage or injury while I/We are at this show or otherwise.

_______________________________________________________________________________

Signature Date

Fee:

6 foot table $30.00 No. of tables ____________ Enclosed $ ________________

Sunday Breakfast Brunch $7.00 No. _________ Enclosed $ ________________

Total Enclosed $ ________________

NO REFUNDS AFTER MAY 1, 2005

FOR CONFIRMATION, PLEASE SEND S.A.S.E

Please make checks payable to: North Platte Wood Carvers Club

Mail To : Paul Jeske

920 Tomahawk Rd., North Platte, NE 69101