Name *

First Name

Last Name

Phone *

Country

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Form of Payment

Please indicate whether paying by Zelle, Venmo, Check or Cash and whether in advance or at the door. Thank you.

Zelle (arteconelcorazon@gmail)

Venmo (@marianadelavega)

Check (Payable to Mariana de la Vega Gallery)

Cash

Payment in Advance

Payment at Door

Scholarship Assistance Requested

Full Scholarship - $69

Partial Scholarship - $30