Adult Registration Form

Print and mail, fax or bring to:
Shiawassee Arts Center, 206 Curwood Castle Drive, Owosso, Michigan 48867
Fax: 989.729.9134


ADULT CLASS REGISTRATION    		Member_____Non-Member_____

(Payment due with registration) ____ Adult SAC Annual Membership $25

Name_________________________		Class_________________Date______________

Address_______________________		_____________________Date______________

City________________ZIP________		_____________________Date______________

Home ph______________________		

Wk ph   _______________________	


Total Payment:_____________________ 
Payment Type:     /  / Check   
                  /  / MasterCard     
                  /  / Visa      

Credit Card#
_______/_______/_______/_______

Expiration Date____________________ 


Signature__________________________