registration.html

Registration Form 2007 - 2008, Dance Academy > School of Music > University of Louisville

Registration Form 2007 - 2008, UofL Dance Academy

PLEASE PRINT

Date received in office ____/____/_____

Student’s Name_____________________________________

Address____________________________________________

City_______________________ State______ Zip__________

Birth date_____/_____/________ Gender M_____ F_____

Parent’s Name______________________________________

Phone_____________________________________________
(Home) (Work) (Cell)

E-mail address______________________________________

Assigned Level /Day_________________________________

SEMESTER	FALL	SPRING

Number of classes /week	___________	___________

Tuition amount (-10% if second child)	$___________	$___________

Registration fee $20 (Waived if paid by) Aug. 3 Dec. 17	$___________	$___________

TOTAL	$__________	$__________

Amount enclosed	$__________	$__________

Make checks payable to: UNIVERSITY OF LOUISVILLE

Mastercard/VISA no._________________________________

Expiration date_____/_______ (only if paying by credit card)

Signature___________________________________________

Please print this form and mail to:

University of Louisville Dance Academy
School of Music
Belknap Campus
Louisville, KY 40292