Name____________________________________________________________________________ Address__________________________________________________________________________ _________________________________________________________________________________ Phone(Home) ____________________Work:____________________Cell:___________________ E-mail____________________________________________________________________________ MIX IT UP- Developing your painting style Fort East Martello Museum And Gardens 3501 South Roosevelt Blvd. 9:30 am. – 12:30 pm. January 12, 19, 26; Feb. 2, 9, 16, 23; March 1, 8, 2008 Cost: $230 with 10% discount for KWAHS members / supplies not included. A CLASS SCHEDULE AND MATERIALS LIST WILL BE PROVIDED AT TIME OF REGISTRATION Tuition Amt.______________ Please circle one) Cash Check Credit Card Credit Card Type: Amex Visa Mastercard (Please circle one) Credit Card#______________________________________________________________________ Exp. Date:________________________________________________________________________ Authorized Signature_______________________________________________________________ Make checks payable to KWAHS Send to: KWAHS, 281 Front Street, Key West, Fl 33040 Attention: Suzanne Pereira Education Contact; Suzanne Pereira 305-295-6616 Ext 27 spereira@kwahs.org Fax # (305)-295-6649