Monthly Payment Form NSAM

Newport School of Artistic Movement

Session & Monthly Payment Form
Student Name*

First NameLast Name
Email
example@example.com
Date of Birth*

MonthDayYear
Are you making a payment for additional dancers?

YesNo
Name of additional dancer

First NameLast Name
Name of additional dancer

First NameLast Name
Name of additional dancer

First NameLast Name
Name of additional dancer

First NameLast Name
Please elect the Month or Session you are paying for:

Session II Nov. 30 - Feb. 5Session III Feb. 8 - April 9Session IV April 9 - May 27JanuaryFebruaryMarchAprilMay
Payment

Class Rates:

Class	Monthly Rate	Full Session
Level 1/2	$45	$85
Level 3/4	$85	$161
Level 5/6	$105	$199
Choreography/Composition	$30	$50
Sister Stretch	$30	$50
Pointe Strenghtening	$30	$50
Quick Picks $5/2 picks	$20	$40

Full session rates include a 5% discount

Family rates available. NSAM family rate allows all family members to be counted as 1 student taking multiple classes.

Tuition is due the 1st class of each month. There is a $10 late fee for payments after the 15th of each month. There is a $25 fee for all returned checks.

NSAM does not pro-rate of refund tuition. Make-up classes are available and is advised.

For more information and questions please email or call;

pdedance@msn.com / (541)961-2316
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Select your classes and payment option here
A 5% discount is applied to a full session payment.

FAMILY RATES - for family rates select the family rate options at the end of this section.
prevnext( X )
Level 1/2 $45.00
Ages 4-7 Wednesday 2:00-2:40

Payment Options

Level 3/4 $85.00
Ages 8-11 Tues/Thurs 4:00-5:00

Payment Options

Level 5/6 $105.00
Ages 12 and up Mon/Wed/Thurs 5:15-6:15 $105

Payment Options

Pointe Strengthening $30.00
Ages 10+ Tuesday 5:30-6:00

Payment Options

Choreography/Composition $30.00
Learning through improvisation and collaboration Fri. 4:00-4:40

Payment Options

Sister Stretch/Covid Bubble Buddies$30.00
Partner with a sibling or friend in your bubble/pod

Payment Options

Quick Picks $5.00
10 minute intensive class $5 for 2 picks (only available in pairs) $20.00/month

Payment Options

Family Rate Level 1 thru 6 MONTHLY$85.00
For families with multiple students, select the total number of regular level classes your dancers are taking each week. If you are also taking specialty classes, please select those below.

Classes per week

Family Rate Level 1 thru 6 FULL SESSION$161.00
For families with multiple students, select the total number of regular level classes your dancers are taking each week. If you are also taking specialty classes, please select those below. THIS OPTION IS FOR PAYMENT OF THE FIRST FULL SESSION OF CLASSES and includes a 5% discount.

Classes per week

Family Rate Specialty Classes MONTHLY$30.00
For families with multiple students, select the total number of SPECIALTY CLASSES your dancers are taking each week. Be sure to select your regular leveled classes above.

Quantity

Family Rate Specialty Classes FULL SESSION$50.00
For families with multiple students, select the total number of SPECIALTY CLASSES your dancers are taking each week. Be sure to select your regular leveled classes above. THIS OPTION IS FOR PAYMENT OF THE FIRST FULL SESSION OF CLASSES and includes a discount.

Quantity

Late Fee$10.00
A late fee should be selected if payment is being made after the 15th of the month or start of session.

Total $0.00
I would like to make my payment with*

Cash/CheckPaypal
If paying with cash or check, you may deliver or mail payment to:

454 SW 7th St. Newport, OR 97365

Please make checks payable to: NSAM.

Checks and cash will be applied on date received. All checks and/or cash must be submitted in an envelope and clearly marked with students name, level and the date.
Should be Empty:

Newport School of Artistic Movement

Payment

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