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Art Class Registration -Form Fill

Section One
Q1

Name

First Name
Q2

Name

Last Name
Q3

Age
Q4

Gender
Q5

Phone Number

Phone Number
Q6

Email
Q7

Address

Street Address
Q8

Address

Street Address Line 2
Q9

Address

City
Q10

Address

State / Province
Q11

Address

Postal / Zip Code
Q12

School Name
Q13

School Level
Q14

Write something about yourself
Q15

Parent/Guardian Name

First Name
Q16

Parent/Guardian Name

Last Name
Q17

Relationship
Q18

How do you learn about this online art class?
Q19

Do you want to add enroll more students?
Q20

Registration Fee
Q21

Payment Method
Q22

Signature of Student
Q23

Date Signed

Date
Q24

Parent/guardian Signature