Adult Class Registration
FALL 2021
Student's Name
*
Mr.
Ms.
Prefix
First Name
Last Name
Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary Contact Number
*
-
Area Code
Phone Number
Secondary Contact Number
-
Area Code
Phone Number
E-mail
*
Emergency Contact
First Name
Last Name
Emergency Contact Number
-
Area Code
Phone Number
Choose Start Date
*
/
Month
/
Day
Year
Choose Class Day/Time
*
Tuesday 4:30 - 6:30 PM
Thursdays 1:00 - 3:00 PM
Saturday 10AM-12PM
Saturday 1-3 PM
My Products
prev
next
( X )
Registration Fee Required Annually
$
35.00
Supply Fee Required For Each Semester
$
25.00
Adult Class Monthly Registration - Once A Week Class (4 Lessons)
$
150.00
Fall Semester (September - December) Save $60
$
540.00
Spring (January - May) Save $75
$
675.00
Enter coupon
Apply
Total
$
0.00
Credit Card
First Name
Last Name
Credit Card Number
Security Code
Expiration Date
Postal Code
Back
Next
Save
How did you hear about The Houston School of Art & Design?
Driving By
Ad
Friend
YELP
Google
Internet Search
Facebook
Please list any diagnosed medical conditions the school needs to be aware of
Additional Notes
I give my permission for my photo and artwork to be used in promotional material. Only first name, last initial and age will be used for credit line.
Student's Signature
*
Clear
Today's Date
*
Save
Register Class
Print Form
Should be Empty: