REGISTRATION FORM

September 10-14, 2023

(Arrive on Sunday, Sept. 10 Classes Sept. 11-14)

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. 11-14

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:

CJ Laster

6950 W. Arrowhead Dr.

Frankfort, IN  46041

614-582-7732  [email protected]