Homeschool Book Club Registration Form

Homeschool Book Club for Early Elementary Students (Recommended for students ages 6–9)

An Eye for Color: The Story of Josef Albers by Natasha Wing

Tuesday, April 27, 2010, 10 a.m.–noon

Parent’s name______

Phone ______E-mail______

Address______Street City, State Zip Code

Homeschool group (if applicable) ______

Child’s name Age (must be 6–9 years old)

______

If you need additional room, please attach a sheet with the children’s names and ages.

I am paying: _____ museum members: $20 per child

_____ nonmembers: $25 per child

If paying by credit card:

Type of card (please circle one): Visa MasterCard American Express

Name on card ______

Card number ______Expiration______

Signature ______

To register, please call 817.989.5030 or e-mail [email protected] to place your name on the list. Credit card payments are accepted by fax or phone. Checks should be made payable to Amon Carter Museum and mailed to the address below. A confirmation notice will be sent only when payment is received.

Homeschool Workshops Amon Carter Museum 3501 Camp Bowie Boulevard Phone: 817.989.5030 Fort Worth, Texas 76107-2695 Fax: 817.989.5039

Payment for each program is required in advance and is nonrefundable.