Registration Form







Home Phone_______________________________Work_______________________________  




1st choice

Course Title: __________________________________________________  


Day & Time:____________________________________


Tuition $ ______________ 


Materials & Firing Deposit: $50


Total: $______________


2nd choice (back-up class in case 1st choice is full or cancelled)

Course Title: _________________________________________________


Tuition $ ______________    


Day & Time:___________________________________


Materials & Firing Deposit: $50


Total: $______________


It is assumed that all students have read, understand and agree to: Studio Policies; Prices; documents located on the Academy website:

Refunds will be issued only if a class is cancelled, in which case you will be notified within 48 hours of the first session. Also note that your tuition covers the ten-week session, not broken down into individual classes. Your tuition cannot be prorated for individual classes.

NY/NJ ACA is not responsible for providing makeup classes or issuing refunds for classes missed as a result of illness, emergencies, weather conditions, absenteeism, or any situation beyond our control.

I understand fully, and agree to the above stated refund policy.




______Please charge my credit card.   MC / Visa / AmEx/ Discover


#_____________________________Expires_________*Security Code: __________

* This three or four digit number can be found either on the front (Amex) or on the back of the card (Visa/MC) on or near the signature strip. Submitted registration forms without this number are not valid.


Name as it appears on the card



Billing address for the card, if different from the address above: