J JEWELRY MAKING CLASS
& Gemstone Setting
Web: www.renatojewelers.com
E-mail: renatojewelers@yahoo.com
1001 McKinney Street A-1 Houston, Texas 77002 Phone 713-739-7955
Admission Application
1 Personal Information
First Name: ___________ MI: _____ Last Name: _________________
Address: ______________________ Apt: ______________________
City: _____________________ State: __________ Zip: ___________
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Day Phone: _________________ Eve Phone: ___________________
Fax: _______________________ Cell Phone: ___________________
E-Mail: ________________________
Gender: Male: _________ Female: ___________
Date of Birth: ___________________
Social Security #: _________________
Drivers License#: __________________
Primary Language: _________________
Country of Citizenship: ______________
Country Of Origin: ________________
I would like to sign up for Basic Jewelry Making __
Jewelry Technician __ Bench Jeweler __ Jeweler Designer __
Sign Up Now
Print, Sign Up with $200.00 deposit.
