SUMMER STUDIO ART PROGRAM 2015
June 1st to August 15th
REGISTRATION FORM
Student’s Name and Last Name: __________________________________________________________________________________
Age:__________
Date of Birth:____________________________
Gender:_______________________________
Parent/Guardian’s name (in case of minor age students)_________________________________________________________
Address:______________________________________________________________________________________________________
City or Town:_______________________State_________________________________________Zip Code:______________________
Phone number:___________________________________________
Cell Phone:____________________________________
Email (please print clearly):_______________________________________________________________________________________
Alternative contact: Name:________________________________________________
Phone:______________________________
Previous art studies:____________________________________________________________________________________________
Occupation: ___________________________________________________________________________________________________
REGISTERING TO THE CLASS: (mark with an X the class and tuition of your choice)
HALF DAY AM (____) Mon to Fri- from 9:00 to 12:00 am
Tuition Payment:
Weekly 350 $ (____)
HALF DAY PM (____)Mon to Fri- from 1:00 to 4:00 pm
Monthly 1200 $ (____)
Complete Program 2800 $ (____) 11 weeks
Dates: Weekly class starting on _____/_____/_________ Month: June (___) July (__)
FULL DAY (____) Mon to Fri -from 9:00 am to 4:00 pm.
Tuition Payment:
Weekly 500 $ (____)
Monthly 1500 $ (____)
Complete Program 3500 $ (____)11 weeks
Dates: Weekly class starting on _____/_____/_________ Month: June (___) July (__)
EVENING CLASS (____) Monday, Tuesday and Wednesday from 5:30 to 8:30 pm
Tuition Payment:
Weekly 210 $ (____)
Monthly 730 $ (____)
Complete Program 1600 $ (____)11 weeks
Dates: Weekly class starting on _____/_____/_________ Month: June (___) July (__)
SATURDAY ART CLASS (____) Saturdays from 9:00 am to 1:00 pm.
Tuition Payment:
Per class 70 $ (____)
Monthly 200 $ (____)
Complete Program 450 $ (____)11 sessions
Dates: Class date _____/_____/_________ Month: June (___) July (__)
Note: Saturday art class included in all the programs with the enrollment of the monthly or complete program tuition.
Date: _____/_______/_______
_______________________________________
Applicant’s Signature
or signature of Parent /Guardian’s (in case of minor age students)
Payment amount: _________________________
Payment method: _________________________
Notes:__________________________________
_______________________________________
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