ART REGISTRATION 2007
19 Fairway Place
Boonton, NJ 07005
(973) 263 – 2484, (973) 723 – 1130
Web site: www.anjusaran.com
Email: anjusaran@yahoo.com

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Name: First _____________________________     Last_________________________________

(Please fill this if you are under 18):
Guardians: Mother:______________________  Father:________________________________

Address  ______________________________________________________________________

Age: Check One:  Child(6-12):_____       Teen (13 to 17) ______  Adult (18 and above) _______

Please check the session you want to enroll:

____ Session 1 – Watercolor

____ Session 2 – Pastel color

____ Session 3 – Free hand drawing and coloring with crayons & pencil colors

____ Session 4 – Oil color

____ Session 5 – Portraits

Amount enclosed: $____________

Phone (Day) ___________________(Eve.) ______________________(Cell)_________________

Fax____________________________ Email _________________________________________

Emergency Contact: Mr./Mrs./Ms._________________________ Phone___________________

(Please mail the registration form along with the check or deliver the form with check/cash to the address printed at the top)

Discounts

NOTES:

 

Signature of Parent/Guardian__________________________         Date______________________