About Your Organization Organization Name Organization Street Address Address 1 Address 2 City State/Province Zip/Postal Code Country Organization Type PTA PTO Private School Religious Organization About You After-school contact name First Name Last Name Your title/role in the organization After-school email * Phone (###) ### #### Your program request How many weeks would you like to offer pottery? 6 weeks / $215 per child/ all materials included 8 weeks / $235per child/all materials included (most popular) 9 weeks /$265 per child/all materials included 10 weeks /$285 per child/all materials included Where will the pottery class be held in your school? (Art room or Class Pod with sink preferred) What time would you like pottery to start and end? ( i.e. 3:15pm-4:15pm) What day would you like to offer pottery? (Choose a day with no Art competition) List all the dates pottery will be offered (i.e. 1/4, 1/8, 1/12, 1/15, 1/18, 1/21) Will there be any holidays or teacher workdays during the pottery session? If yes, please list the date(s) Student Scholarship: Would you like to offer for the entire year (Fall, Winter & Spring) If yes, we will honor one student scholarship per season. Student will be chosen by the PTA. Thank you for your request!We will review your application and will be in touch within 1-2 days.Got questions? Email us at jimmy@jimmypotters.com or call us (703)862-1300