REGISTRATION FORM:  Drawing Classes for Students 9 - 18 with Cathie Fithian

Student's Name _______________________________________________________

Street Address: _______________________________________________________

City: _____________________________  State: _________  Zip: _______________

Home Phone: _________________________ Work Phone: ____________________

Parent's Names: ______________________________________________________

School: ____________________________ Grade: __________  Age: ___________

Payment enclosed:  _____ $60 Deposit  _____ $120 Payment in full for 8-week session

                                   (Please make checks payable to Cathie Fithian)

Mail to:
Cathie Fithian
The Linden Tree Fine Art Studio
 543 North Main Street,
North Canton, OH 44720