My Art Workshop - Register Online

2008-2009

Early Release Program

PEIFFER

A Fun After School Arts and Crafts Enrichment Program for 1st through 6th Graders with 2% of fees donated back to your school!

All you need is your Imagination!
Each club meeting lasts two hours.
At Peiffer we meet in the Art Room
A minimum of 10 registered students is needed in each club.
Sibling Discount $4.00.

Please remind your child of the club meeting dates. Confirmation will not be sent. Parents are requested to pick up their children promptly. Please send a paint shirt with your child for every session. My Art workshop is not responsible for stained clothing

Please select the dates for which you would like to register

Select the class or classes you would like
	September 3, 1:10 - 3:10, $24.00 plus Facility Fee $2
	October 1, 1:10 - 3:10, $24.00 plus Facility Fee $2
	November 5, 1:10 - 3:10, $24.00 plus Facility Fee $2
	December 3, 1:10 - 3:10, $24.00 plus Facility Fee $2
	January 7, 1:10 - 3:10, $24.00 plus Facility Fee $2
	February 4, 1:10 - 3:10, $24.00 plus Facility Fee $2
	April 8, 1:10 - 3:10, $24.00 plus Facility Fee $2
	May 6, 1:10 - 3:10, $24.00 plus Facility Fee $2

Contact Information:

First Name
Last Name
Phone
Fax
E-Mail
Childs Name and Age:	(John Doe, Age 7)
Will you have a sibling in this program?	Siblings Name and Age

Comments/Coupons?

PAYMENT

Credit Card #

Expires (08/08)

Type MC/VI only

Credit Card Billing Address

Street Address

Address (cont.)

City

State/Province

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Country

	Credit Card Billing Address
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country

My Art WorkshopCopyright 2008 [TWrightDesign]. All rights reserved. Revised: 10/09/08

My Art Workshop
Copyright 2008 [TWrightDesign]. All rights reserved.
Revised: 10/09/08