Family Style Mosaic Workshop for Spring Break March 15 and 16th
Taught by Stephanie Shroyer at SAC in Schulenburg Texas
Students Registration Form
Fill out the form carefully for registration
Adult signing up for mosaic class Family style
First Name
Middle Name
Last Name
Gender
Please Select
Male
Female
N/A
Name Of Child
First Name
Last Name
Childs Gender
Please Select
Male
Female
Age of child
Please Select
Age 5- 7 years
Age 8- on up
E-mail
example@example.com
Mobile Number
Phone Number
What three colors does the adult want to work with
Red
Orange
Blue
Green
Yellow
Purple
Brown
Black
White
What shape does Adult wish to make?
Please Select
Square Picture Frame
Circle
Heart
Easter egg
Which shape does the child wish to make?
Please Select
Square Picture Frame
Circle
Egg
Heart
Type a question
Red
Orange
Blue
Green
Yellow
Purple
Brown
Black
White
My Products
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Family Style Mosaic
Payment for one child age 5-7 and one adult
$
100.00
Family Style Mosaic
Payment for one child age 8 on up and one adult
$
150.00
Additional participant
$
50.00
Credit Card
Submit Application
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