REGISTRATION FORM FOR ADULT POTTERY CLASSES @ TPG
(Print and mail or deliver with payment)
NAME: ___________________________________________________
ADDRESS: __________________________________________________________
MAIL TO:
CITY: ___________________________________________________
POTTERY CLASSES
STATE: __________________ ZIP: ___________________________
TOLEDO POTTERS’ GUILD
DAYTIME PHONE: ____________________________________________
5403 ELMER DRIVE
EVE./OTHER PHONE: ____________________________________________
TOLEDO, OHIO 43615
E-MAIL ADDRESS: ____________________________________________
SESSION: (circle) Winter (begins Jan. 3, 2012) Spring (TBA) Summer (TBA) Fall (TBA)
CHOICE OF CLASS NIGHT: [ ] Tuesday – 6:30-9pm (Steve Johnston) [ ] Thursday – 6:30-9pm (Kelly Savino)
IF WE OPEN AN ADDITIONAL SECTION, WOULD MONDAY EVENING BE A POSSIBLE ALTERNATIVE FOR YOU? Y / N
FEE OPTIONS: (circle)
OPTION # TUITION (10 SESSIONS) SUPPLY FEE CLAY FEE ( FIRST 25 LB;) TOOLS (NEW STUDENTS ONLY) TOTAL
1 (FIRST TIME) $135.00 $20.00 $10.00 $12.00 $177.00
2 (RETURNING) $135.00 $20.00 $10.00 N/A $165.00
3 (GUILD MEMBER) $121.50 $20.00 $10.00 N/A $151.50
METHOD OF PAYMENT: (circle) CHECK (MADE PAYABLE TO TPG) MASTERCARD VISA DISCOVER
Due to bank policy, please bring credit card to the first class and the treasurer will process your payment.
BY SIGNING THE BOTTOM OF THIS FORM, I AFFIRM THAT I HAVE READ THE TPG BEGINNING POTTERY CLASS INFORMATION
PUBLISHED WITH THIS REGISTRATION FORM. FURTHERMORE, I AGREE TO ACCEPT THE STATED TERMS AND CONDITIONS FOR
PARTICIPATION IN THE CLASS, INCLUDING INSTRUCTIONAL OFFERINGS AND CLASS PAYMENTS. CLASS FEES WILL BE REFUNDED
ONLY TO THOSE INDIVIDUALS WHO WITHDRAW PRIOR TO THE FIRST CLASS SESSION, OR IF A CLASS SECTION IS CANCELLED DUE
TO INSUFFICIENT ENROLLMENT.
SIGNATURE: (indicating acceptance of terms) ______________________________________ DATE: _____________________________
Mail or hand deliver this completed registration form along with your payment.
If mailing, please send to the address noted above; envelope must be postmarked no later than 6 days before the first week of class.