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ENROLMENT FORM
Please Complete Form in
BLOCK CAPITAL
Letters
Registration Fee $50.00
Name:
Male
Female
Home Address:
Telephone No. :
Date of Birth:
Age on Last Birthday:
Postal/Mailing Address (essential):
E-mail:
Name of School Attending:
Names of Parents/Guardians:
(name)
(Address)
(home #)
(work #)
(relationship to applicant)
(Name)
(Address)
(home #)
(work #)
(relationship to applicant)
Contact Person in Case of Emergency:
(name)
(Address)
(home #)
(work #)
(relationship to applicant)
Sponsor of Fees for the Applicant:
(name)
(Address)
(home #)
(work #)
(relationship to applicant)
How did you hear about us?
Word of Mouth
Radio Ad
TV Ad
Internet
Promo Literature
Other
Has the Applicant had any previous Classical Ballet and/or Modern Dance Training?
Yes
No
If “Yes”, please answer the following questions
Name & Address of Dancing School Attended:
Number of Years of Training:
Grades Completed:
Allergies/Medical Conditions:
Additional Information:
Fees are to be paid in advance at the beginning of the term.
A late fee penalty will be added to total of fees paid after due date.
A term´s notice must be given in writing to withdraw the student(s) from the school.
Signed:
Name (PRINT):
Relationship to Applicant:
FOR OFFICE USE ONLY
REG. FEE: $
GRADE:
TUT. FEE: $
UNIFORM: $
ADDITIONAL :
INFORMATION
Enrolment Form
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