Therapeutic Art Program Registration: Paint Cafe/Monet1

top of page

Full Name ( First / Last )

Email

Street Address

Name of Emergency Contact ( First / Last )

Your Age

Primary Phone

Town / City

Emergency Contact Number:

Select an option *

Resident of Noble Horizons

Non-Resident of Noble Horizons

Commute to the Art Class: *

I will drive myself

Someone (family/friends) will give me a ride

Noble Horizons will provide a ride

Art Learning Experiences

Never

K-12 School Art Classes

Adult Edu/Continuing Edu

Local Art Programs

Others

If your choice is "Other," Add answer here:

Why Would You Like to Take This Class?

How did you find out about us?

Thanks for your registration.

We'll get back to you soon!

Use tab to navigate through the menu items.

Salisbury, CT 06068

Tel: 203-379-0015

bottom of page