1. First Name

2. Last name

3. Will you be attending Sampler Day 2014?

4. Email Address

5. 5-digit Zip Code

6. Which sample class would you attend at 10 a.m.?

7. Which sample class would you attend at 11 a.m.?

8. Which sample class would you attend at 1 p.m.?

9. Please check all ways you heard about Sampler Day

10. If you would like this survey to serve as your registration for the Sampler Day event and as your entry into the raffle, please indicate your full birthdate below (Sample: Feb. 14, 1950)

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