INVESTIGATING CULUTURAL ART Spring Art Classes 2019Print this Page If you are new student please indicate male or female. Thank you! Name(s)_____________________________(m,f)Age(s) _____ Grade(s) _____ Address__________________________________________________________ Phone __________________ Parent’s Names _________________________ Cell phone_______________Email address___________________________ CLASS Location/Time/Dates________________________________ New student? _____ I give permission for my child to be treated in case of emergency at Mrs.Seitz’ discretion until I can be contacted. Parent Signature __________________________________ Tuition: 1st Child $80 Paid Now___ Paid at 1st Class___ 2nd Child $75 Paid Now___ Paid at 1st Class___ 3rd Child $70 Paid Now___ Paid at 1st Class___ 4th Child $65 Paid Now___ Paid at 1st Class___ Subtotal: __________ If paid at least one week before class subtract $5 on total cost! Total Cost: _________ Check No.:_________ Please send enrollment forms to: 2248 Fairfield Blvd. Plymouth, IN 46563 Make checks out to Gloria Seitz. |