Name/s:____________________________________________________
___________________________________________________________
Age & grade/s:_____________________________________________
Name of guardian(s):_______________________________________
Address:___________________________________________________
___________________________________________________________
City: ________________________ Zip:________________________
Phones: Cell______________________Home_____________________
Work______________________Other___________________________
Email (please print clearly):______________________________
For more information and eligibility please call:
423-320-6738
Classes will be at James A Henry Bldg. SPLASH Art Studio located at: 1200 Grove Street, Chattanooga, TN 37402
Fill out application when you arrive or bring application with you at time of class.