California academy 入会申込書 NASBAC

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NASBACの入会を希望します。
*は必須項目です。

PERSONAL INFO

Name of Applicant*


first	last

Address*

street address, apt/suite #

city

state Zip code

country

Phone no.*

area xxx-xxxx

e-mail*

CLASS INFO

Type of Class(Check any applicable classes)*

Shadow Box Art

Decoupage

Selection of Course (Check any applicable courses)*

	Elementary Course		Intermediate Course		Advanced Course
	Instructor Course		Others

Upon NASBAC's official acceptance to my application, I will follow further procedures as required by NASBAC in order to complete the arrangement for admission.

QUESTIONNAIRE:
I am providing the following information to NASBAC for your reference: (Check any applicable ones and state the information if any)
	I have learned Shadow Box Art in the past for years/months.
	I have learned Decoupage in the past for years/months.
	I became to know NASBAC from one of my friends/acquaintances.
	I became to know NASBAC from any Advertisement in Telephone Book
	I became to know NASBAC from any other Advertisement (specify here: )
	I want to learn Shadow Box Art/Decoupage for my hobby.
	I want to learn Shadow Box Art/Decoupage for my business purpose.