Summer 2023 Registration Form
May 30th - August 25th 2023
Registration
*
New Student
Returning Student
Student Name
*
First Name
Last Name
Age
"A" for Adults
Date of Birth
January
February
March
April
May
June
July
August
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December
Month
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Day
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Year
Name of School Attending
Elementary, Middle or High School
Parent's/Customer Name
*
Mr.
Ms.
Prefix
First Name
Last Name
Primary Contact Number
*
-
Area Code
Phone Number
Secondary Contact Number
-
Area Code
Phone Number
E-mail
*
Invoices and other school updates/notices are sent to email on file
Emergency Contact
First Name
Last Name
Emergency Contact Number
-
Area Code
Phone Number
Please list any allergies or medical conditions the school needs to be aware of
Art Summer School - Once A Week 2 Hours
Tuesdays 3:30 - 5:30 PM
Wednesdays 3:30 - 5:30 PM
Thursdays 3:30- 5:30 PM
Saturday 11:00 AM - 1:00 PM
Choose Start Date
*
/
Month
/
Day
Year
How did you hear about The Artist Within School of Art?
Driving By
Ad
Friend
YELP
Google
Facebook
Additional Notes
I give my permission for my child's photo and artwork to be used in promotional material. Only first name, last initial and age will be used for credit line.
Parent's Signature
*
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Today's Date
*
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Registration Fee
$
35.00
Required for First Time Students
-
New Student
Returning Student Renewal
Returning Student
Summer Supply Fee
$
25.00
Required For Each Semester
Class Monthly Tuition
$
150.00
Once A Week Class (4 x two hour Art Lessons)
Summer Semester
$
420.00
(June - August) Once a week classes Savings of $30
Enter coupon
Apply
Total
$
0.00
Credit Card
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