J'S ART STUDIO REGISTRATION FORM
2009 - 2010

STUDENT NAME__________________________________________________AGE___________Birthday_____________
PARENTS NAMES:____________________________________________________________________________
HOME ADDRESS:_____________________________________CITY____________________ZIP______________
HOME PHONE:_______________________________________WORK___________________________________
CELL:__________________________________PAGER:__________________________OTHER_______________
EMAIL:____________________________________
EMERGENCY CONTACT:___________________________________________PHONE:______________________
DAY and CLASS TIME REGISTERING FOR_________________________________________________________
Deposit amount enlcosed_______________________________________________

PLEASE CALL AHEAD TO CONFIRM THE CLASS TIME AND DAY YOU ARE REGISTERING FOR.
THANK YOU
J'S ART STUDIO
17630 DAVENPORT RD. SUITE 102
DALLAS, TEXAS 75252
972-931-1933