2012 Classes Application Form

Please print, fill out, and return this form to the MAA: 8 Hooper Street, Marblehead, MA 01945.

Date

Name

Address

Phone # (day) Phone # (eve)

Email

Class #1 Day/Time

Class #2 Day/Time

PAYMENT

Class #1  $_______________  Materials Fee $_______________

Class #2  $_______________  Materials Fee $_______________

Total $_______________

Payment Method (check one)     ______ Member   ______ Non-Member

______ Check enclosed (make out to the Marblehead Arts Association)

Mastercard # Exp.

Visa # Exp.

Signature