Student Information
:
Information
o
o
Previously Enrolled
First Time Enrolled
_____________________________________________________________________________
Student’s Name
Parent’s Name
Student’s Age
__________________________________________________________(____)______________
Address
Phone Number
_____________________________________________________________________________
City & State
Zip Code
E-mail Address
What time and days are you planning to attend?
Tuesdays: __________ (date)
o 10:30am-12:00pm Sketching
o 1:00pm-2:30pm Acrylic Abstract
o 2:30pm-3:30pm Art Club
Wednesdays: __________ (date)
o 10:30am-12:00pm Color Theory
o 1:00pm-2:30pm Sketching
o 2:30pm-3:30pm Beginner Film
:
Thursdays: __________ (date)
o 10:30am-12:00pm Clay
o 1:00pm-2:30pm Painting
o 2:30-3:30pm Digital Design
Fridays: __________ (date)
o 10:30am-12:00pm Mix Media
o 1:00pm-2:30pm Painting
o 2:30pm-3:30pm Beginner Photoshop
How where you referred to these lessons _____________________________________
School attending and grade? ________________________________________________
Art Experiences/School if any: ________________________________________________
What is your goal in developing your artistic skills? ___________________________
_____________________________________________________________________________
Tuition and Fees
:
Tuition and Fees
$ ___________________ Tuition ($70/Day or $259/Week)
$ _______________________ Sales Tax (8.25%)
$ _______________________ Total Amount Due
Payment
Payment
:
o
My check is enclosed.
o
Charge payment to my credit card: (circle)
Visa
MasterCard
o
PayPal Payment
American Express
Discover
_____________________________________________________________________________
Card number
CVC
Expiration Date
_____________________________________________________________________________
Name as it appears on card
Zip
Signature