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WINTER 2012 WORKSHOP REGISTRATION FORM 


Please print, fill out completely and return with payment for each student. 
 

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Student Name  							 Parent or Guardian Name (if under 18)


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Home Phone /Cell                                                                Emergency Contact/ Ph#


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Street Address
 

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City/State/Zip Code                                                                    Email Address 
  

Check applicable class:

CERAMICS $260 ____ (includes $20 materials fee)
DRAWING/PAINTING $220 ____
CREATIVE WRITING $240 ____
MULTIMEDIA $240 ____ 
ARCHITECT. DESIGN $240 ____
TEEN FICTION $240 ____ 
URBAN PHOTOG. $280 ____
 

Adult Classes: 
CERAMICS $270 ____ (includes $20 materials fee) 
EVERYONE CAN DRAW $300 ____
WATERCOLOR $240 ____

Total Amount Enclosed: _______ 
For your convenience, fees can be split into two payments. 
1st Payment: ______
Balance: ______

REGISTRATION PROCEDURE: 
Choose one of three ways to register for Place classes 
 By mail with a completed registration form and check. 
 In person with cash, check, or credit card. 
3) Call Place with your registration and credit card information. 
Class Places are held only for registrants who have paid a deposit of half the class tuition fee prior to the first day of class.
 
REFUND POLICY: 
 * To withdraw from a class and receive a full refund, the request must be made at least 10 days prior to the beginning of the session. 
 Classes with insufficient enrollment may be canceled or postponed. If Place cancels a class before the first meeting, a full refund will be issued automatically or, if preferred, credited toward another class at Place.


We look forward to seeing you at Place!

Place 1506 Mission Street South Pasadena, CA 91030 626.441.4788 Placeartscenter.com