Class Days: _____________________________________ Time:___________________

Workshop Title: __________________________________________________________

Name: _________________________________________ Child's Age: _____________

Address: ________________________________________________________________

City: _______________________________________ State:______ Zip: ____________

Phone - Home: ____________________________ Work: ________________________

• $ ___________________ Fee

• $ ___________________ Workshop Fee

• $ ___________________ TOTAL

Enclosed is a $_______________ check or money order payable to Pewabic Pottery.
We accept VISA and MasterCard

Signature (as shown on card): _____________________________________________

Account Number: __________________________________exp. date: _____________

Basic pottery tools can be purchased at the Gallery during regular business hours: Monday - Saturday 10:00am - 6:00pm