Registration Form:  CUT, PASTE, PRINT
and send with deposit to hold your spot :-)


SPRING  2012
Artist’s name: _________________
2nd Artist’s name: _______________
Ages: _____ Birthdates: _________
Address: _____________________
City_____________zip__________
Home Phone: ___________________
Cell phone: _____________________
EMAIL:  ______________________
HOW DID YOU HEAR ABOUT THE STUDIO?
_________________________________
Class Attending:
Mon. Tues. Wed. Thurs.  (please circle)
Time of Class:  ____________
*********************************
Any information I should know about this artist?
(kept confident)_________________
I understand that my deposit holds
my child’s spot. If there is a conflict,
my deposit can be used for another time.
Print parent’s name_______________
                                  Please PRINT
Signature of parent ______________
To secure your spot, mail or drop off
 with your deposit:
Jan's ART Academy
1923 S. Beckham Ave  
Tyler, TX 75701

Thank You, Blessings !