For printable version of form click the link above

REGISTRATION FORM

September 13-17, 2020

(Arrive on Sunday, Sept. 13 Classes Sept. 14-17)

NAME________________________________

ADDRESS_____________________________

CITY_________________________________

STATE & ZIP__________________________

HOME PHONE & CELL__________________

____________________________________

EMAIL_______________________________

EMERGENCY CONTACT & PHONE

_____________________________________

LIST SPECIAL NEEDS (FOOD ALLERGIES ETC.)

________________________________________

4 DAYS * M-T* Sept. 14-17

1.________________________________________________

2.________________________________________________

3.________________________________________________

4.________________________________________________

Make Checks Payable to:

PORCELAIN ART SCHOOL OF INDIANA

Send $75 non-refundable deposit

(or full tuition) and this registration form to:

CAROLYN JUNG

4301 E CR 150 N

AVON, IN 46123