Registration Form

Adults Classes
and Workshops
 
Mail this form to: 
Visual Arts  Mississauga
4170 Riverwood Park Lane  Mississauga, ON L5C 2S7
Or Fax to: 905-277-4340		 Are you a member of
  Visual Arts Mississauga?
  Yes ____    No  ____		 Become a member of 
Visual Arts Mississauga!
Annual adult membership costs $25.00 and runs from 
August 1 - July 31 the next year.		  
Date: ______________________
Name:       ______________________________  
Address:   ______________________________     City:  __________________  Postal Code:_____  
Home # ____________________    Bus. ___________________    Cell_______________ 
5%gst                  
Code Class/Workshop Level Day Start Date Time   Amount

 
                 
                
               
               
Cheque _______   (Make cheques payable to: Visual Arts Missississauga) gst 

  
Visa #_______________________________________ Exp. _____/_____    
MasterCard # ________________________________  Exp. _____/_____ Membership fee  
(Please tick) ______ I consent to receive information about all Visual Arts Mississauga promotions, events, courses workshops and meetings. TOTAL  

                                                   

                                Thank you. Your registration will be processed and a confirmation receipt will be mailed to you.

                                                                   

                                             Print out and complete the form, then mail or fax to Visual Arts Mississauga.

 
               
               
Visual Arts Mississauga All Rights Reserved                
                 
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