The Porcelain Art School of Indiana
REGISTRATION FORM
September 11-15, 2022
(Arrive on Sunday, Sept. 11 Classes Sept. 12-15)
NAME________________________________
ADDRESS_____________________________
CITY_________________________________
STATE & ZIP__________________________
HOME PHONE & CELL__________________
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EMAIL_______________________________
EMERGENCY CONTACT & PHONE
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LIST SPECIAL NEEDS (FOOD ALLERGIES ETC.)
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4 DAYS * M-T* Sept. 12-15
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