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Class Name

Class Date and Time

Class Cost


Cost of Materials

Student First Name

Student Last Name

Student Age (if under 18)

Parent or Guardian Name (if applicable)

Address

City

State

Zip Code

Phone Number

Email Address

Cardholder's Name

Card Number

Expiration Date

Does the student require any learning accommodations?

Does the student have any allergies we should be aware of?

How did you hear about classes or workshops at the Kimball Art Center?

What classes or workshops are you interested in taking at the Kimball Art Center? What time of year are you intersted in taking classes or workshops?




Is there any additional information you would like us to know?


Kimball Mailing List

Email: