Class Registration Form

Simply print, complete and return this form to:

Stained Glass Corner with total payment.

Don't delay-the classes fill up fast!

Name:    

Address:  

City:             State:   Zip Code:  

Phone Number:   Home:                                      Work or cell:                            

Email Address:    

Choose your class and call for availability.

Class Name	Date and Time	Cost
	Total Cost:

Payment method:

Check enclosed    or charge to my Visa    M/C     Discover  Amex 

Card #    Expiration          /        

REFUND POLICY:   A 100% refund will be given if cancellation is requested two weeks prior to the first class.  A 50% refund will be given one week prior to the first class.  No refund will be given on the first date of class.

Signature:

Please print this form and return with payment to:

Stained Glass Corner

16085 Perry Highway

P.O. Box 2005

Warrendale, PA 15086

(724) 93 GLASS    or 1-866-469-3619