Student Enrollment Form All students may be placed on same form.

 

EXPLORING DRAWING Fall Art Classes 2018

Print 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 save $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.

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