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Enrollment Form

Download Enrollment Form

Please fill out all items in bold.
First Name: Last Name:
Mailing Address:
  STREET CITY PROV./STATE POSTAL/ZIP
Phone (home): Phone (work):
 E-mail:
Fax: Date of Birth:
(mm/dd/yy)		 E-mail:
I have read, understand, and agree to the policies and procedures on the reverse of this form.
Name:  
  NAME OF PARENT/GUARDIAN IF UNDER 18
DISCIPLINE(S)      
Please check all that apply    
Bagpiping Drumming Highland Dancing Step Dancing Other
WEEKLY LESSONS
Location:      
  Local (Summerside) Extension (Charlottetown) Other  
Class Type:      
  Group Lesson Semi-Private Lesson Private Scholarship
PAYMENT INFORMATION LESSON DETAILS
Balance Forward
Tuition Fee
Less 5% (if paid in full)
Less 10% (3+ Family)
Total
Payment
Balance Owing
Future Installments Payable
January 1 & April 1
1. Discipline:
  DAY: TIME:
  FEE/ANNUM:
2. Discipline:
  DAY: TIME:
  FEE/ANNUM:
3. Discipline:
  DAY: TIME:
  FEE/ANNUM:
4. Discipline:
  DAY: TIME:
  FEE/ANNUM:
OTHER PROGRAMS
  Summer School Workshop Session Dates:
  Custom-Study Internship Scholarship (if applicable):
NOTES:


 
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