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Pottery Class Form

Name

First Name

Last Name

Date

YYYY

Class Type

pick one

Initials/engraving on the bottom

please make sure this is EXACT

Glaze Color

pick one

Phone

(###)

###

####

Disclaimer

1. The nature of hand-building pottery, there is a chance of minor imperfections in the final product that shouldn't impact the functionality of your piece. 2. I consent to allow Jars of Dust to remake my piece for me in the event that it becomes cracked or broken in the firing process.

SHIPPING

(leave blank for local pick up)

Do you need your piece shipped?

Yes

If yes, please provide your shipping address:

And pay $15 for shipping/handling charges with your instructor at the front desk

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country