ART FOR WELL BEINGS
REGISTRATION FORM
STUDIO RATES
Honest Earnest ARTIST
8-WEEK series $120
Drop-In $ 25
Growing Art
8-WEEK series $120
Drop-In $ 25
REGISTRATION FORM
___ Honest Earnest ARTIST
___ Growing Art
Today’s Date ________
Session Times: __________________
Name: _________________________
Address: _______________________
City: _________ ST: ___ Zip: ______
Birthdate: ______________M __ F __
Home Phone: ___________________
Email: _________________________
Emergency contact: ______________
Emergency phone: _______________
Payment: ____ check __ Visa / MC
Account #: ______________________
Exp. Date: _______
Signature: ______________________
_____ I give ART FOR WELL BEINGS Permission
to use any photos of me and to use my artwork.
Please Fax to 650.855.9067 or mail to:
ART FOR WELL BEINGS
Emerson Center
2800 West Bayshore Road, Palo Alto, CA 94303
To register for classes offered, please download the form below and fax to: 650-855-9067
Phone: 650-776-8297
Fax: 650-855-9067
Registration Form
ART FOR WELL BEINGS
Emerson Center 2800 West Bayshore Palo Alto, CA 94303
650.776.8297
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