Potters Place
Registration Form

127B Old West Street, Walpole, Massachusetts 02081
For more information, call 508-668-0363 or call the class instructor

Potters Place is a not-for-profit corporation. Our mission is to share the pottery experience with out neighboring communities through classes, workshops and special projects. We gratefully accept tax deductible contributions.

Name __________________________________________   Phone Day (_____) ____________________

Address ________________________________________         Evening (_____) ____________________

City/State/Zip __________________________________    E-mail _______________________________

Class/Workshop ________________________________    Instructor ____________________________

Day/Hour ______________________________________

Please make checks payable to the instructor of your Class Workshop

c Adult Class-6 weeks, $200 plus firing fees   c Kids Classes-6 weeks, $130 includes firing fees

c Teen Class-6 weeks, $150 plus firing fees

Amount Enclosed $___________

Payment in full must accompany registration. 50% refund after first class. No refunds after second class.

Please print and return this form with your registration fee