2023 Studio ENROLMENT FORM

ENROLMENT FORM 2023
Melani School of Dance has always respected the privacy, security and online safety of the members'personal information. We take our responsibility to protect their information very serioulsy. Information is stored in a file and / or on a computer. Once a member opts out of receiving information from Melani School of Dance, all information is immediately destroyed by shredding if printed onpaper / deleting if stored on a computer. We assure you that your privacy remains our priority.
Dancer's Name (as per certificate)*

First NameLast Name
REGISTER FOR

BalletModern DanceJunior Contemporary (9-10 years)Senior ContemporaryTapAcrobaticsAdult dance classI AM NOT SURE (new student) Please contact me
CLASS ALLOCATION (select: "unsure" at the bottom, if you are not sure of your class allocation)*

PRE-PRIMARY BALLET (Grade 1 at school)PRE-PRIMARY MODERN (Grade 1 at school)PRIMARY BALLET (Grade 2 at school)PRIMARY MODERN (Grade 2 at school)GRADE 1 BALLET (Grade 3 at school)1ST GRADE MODERNGRADE 2 BALLET2ND GRADE MODERNGRADE 3 BALLET3RD GRADE MODERNGRADE 4 BALLET4TH GRADE MODERNGRADE 5 BALLETFINAL GRADE MODERNPRE-ELEMENTRY MODERNINTERMEDIATE FOUNDATION BALLETELEMENTARY MODERNINTERMEDIATE BALLETINTERMEDIATE MODERNADVANCE FOUNDATION BALLETADVANCE 1 BALLETADVANCE MODERNJUNIOR CONTEMPORARYSENIOR CONTEMPORARYTAP FOUNDATIONTAP SENIORSACROBATICS LEVEL 1ACROBATICS LEVEL 2ADULT DANCE CLASSUNSURE
FOR OFFICE USE
Dancer's Date of birth*

MonthDayYear
Date
Age as per the 1st of January 2023*
School attending*
Grade at school 2023?*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mothers' Name*
Mothers' phone number*
Mothers' Email (general info)*
example@example.com
Fathers' name*
Fathers' phone number*
Method of payment*
ACCOUNT HOLDER ID Number*
DEBIT ORDER MANDATE FOR MONTHLY FEES
Accounts Email*
example@example.com
My Products
prevnext( X )
Registration fee R200Receive your free T-shirt on registration
200.00ZAR

Total

0.00ZAR
T-shirt size*
Please tick box as applicable. I agree to:
NEW STUDENTS
How did you hear about us? Who is your referral?
Previous dance experiance?
Institution / Studio name?
Contact details
I hereby declare that I understand the terms and conditions and understand that this registration contract represents a financial commitment for the classes I have indicated above. I do hereby accept full responsibility for the full settlement of the account when it is due at the beginning of each month. I have read the registration information and understand the school's calendar and policies as outlined. I declare that all information submitted by me is complete and accurate.*

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Disclaimer: The information contained in this communication from the sender is confidential. It is intended solely for use by the recipient and others authorized to receive it.
Notes to Teacher
Should be Empty:

ENROLMENT FORM 2023

NEW STUDENTS

Disclaimer: The information contained in this communication from the sender is confidential. It is intended solely for use by the recipient and others authorized to receive it.