Chimera Class Attendance Form

Chimera Class Attendance Form

Submit this form (or its paper equivalent) to Chimera Accounting for payment.
Class Name*
i.e. Laser Cut Night Light
Instructor Name*

First NameLast Name
Instructor Email*
example@example.com
Class Date*

MonthDayYear
date the class was held
Class Fee per Student*
typical amount per ticket - don't include fees
Attendees*
Preferred Instructor Payment Method

Melio -Direct DepositMailed CheckDonate payment to ChimeraCheck Pick-up (at Chimera front desk)Other
Payments are securely processed through our accounting team using Melio; please email your bank account and routing numbers to accounting@chimeraarts.org
Would you tike to use Melio

YesNo
If mailed-not Melio, specify address to send payment to
i.e. PayPal email address, mailing address
Instructor Signature*
Should be Empty: