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2008 |
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All
registration forms must be accompanied by a $75.00 Registration or your full
tuition payment (Registration pmt. will be applied to tuition). You may pay
by check, Master Card, Visa or Discover Card.
(If paying by credit card you may
fax this form or call us).
Please make Checks payable to Tom
Johnson/PASS. If paying by credit card (MC, VISA, DISCOVER) you may
fax this form to us. |
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PLEASE NOTE: FULL TUITION MUST BE RECEIVED BY MARCH 1, 2008 |
| Name:_______________________________________________________________ | Tel:_______________________ |
| Address:_____________________________________________________________ | Cell:_________________________ |
| City: ________________________________________________________________ | Fax:_________________________ |
| State / Country: _______________________________________________________ | e-mail: _______________________ |
| Zip / Postal Code:____________________________ | |
| PLEASE CHECK THE APPROPRIATE BOXES BELOW: |
| I will attend: A 6 day class OR First 3 day class Second 3 day class Third 3 day class Linen Rental | ||
| I will be a day student & will not be staying in the Dormitory I would like: A private bedroom | ||
| To share bedroom with _________________________________ Share suite with _____________________________ | ||
| Please list in order of preference your choice of teacher(s) (please select 3) | ||
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Six Day Classes: May 19 -24 - Check-In: May 18th |
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Ivonne Planos: 1st piece: Tray with fruit, flower bouquets,
raised paste & gold. 2nd Piece: Box with Bird, flowers, raised paste & gold |
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| San Do: Portrait of a Pretty Lady | ||
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Three Day Classes |
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First
3 Days: May 19, 20, 21 |
Second 3 Days: May 22, 23, 24 |
Third
3 Days: May 26, 27, 28 |
| Alzora Zaremba: Crabs | Alzora Zaremba: Iris | Alzora Zaremba: Crabs |
| Filipe Pereira: Animals | Filipe Pereira: Birds | Filipe Pereira: Animals |
| Mariela Villasmil: Portrait of each Students Choice | Mariela Villasmil: Portrait of each Students Choice | Mariela Villasmil: Portrait of each Students Choice |
| Rickie Nishi: Vase, Meissen style Tulips with modern edging | Rickie Nishi: Vase, Rookwood, Floral | |
| In case of an
emergency contact:
Home Tel:________________________ ___________________________________________________________ Work Tel: ________________________ Relationship: _______________________________ Cell:_____________________________ |
| Use a separate piece of paper to describe any medical condition we need to be aware of (held in confidence). Be sure to include allergies. |
Please fill in blanks and sign the following: On this the ____ day of _____, 2008, I __________________________________ agree that I will not hold The College of Charleston, its employees, PAS-South and its staff responsible for any loss of or damage to my person or personal property while attending the PAS-South classes. I further agree to hold the College of Charleston and PAS-South and its staff harmless from any and all suits or claims resulting from the activities while en route to and from the PAS-South school or during my participation in the PAS-South school or any school activities. My check # _________ for $___________ is enclosed. If paying by credit card please complete the following:
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