Spring 2018 Acting Class Enrollment Form

First Name Last Name

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

- Area Code Phone Number

First Name Last Name

Credit Card Cash or Check ($25 nonrefundable deposit required below) Tuition Assistance

Student 1: "Page to Stage Acting!" (6 - 10) Tuesdays - $185 Student 2: "Page to Stage Acting!" (6 - 10) Tuesdays - $185 Student 1: "Imagination to Life" (4 - 6) Thursdays - $165 Student 2: "Imagination to Life" (4 - 6) Thursdays - $165 Student 1: "Page to Stage Acting!" (6 - 10) Saturdays - $185 Student 2: "Page to Stage Acting!" (6 - 10) Saturdays - $185 Student 1: "Tell-A-Tale Theater" (8 - 12) Saturdays - $200 Student 2: "Tell-A-Tale Theater" (8 - 12) Saturdays - $200

$25 Deposit (I am paying with cash or check) $ 25.00

Student 1: "Page to Stage Acting!" (6 - 10) Tuesdays $ 185.00

Student 2: "Page to Stage Acting!" (6 - 10) Tuesdays $ 185.00

Student 1: "Imagination to Life" (4 - 6) Thursdays $ 165.00

Student 2: "Imagination to Life" (4 - 6) Thursdays $ 165.00

Student 1: "Page to Stage Acting!" (6 - 10) Saturdays $ 185.00

Student 2: "Page to Stage Acting!" (6 - 10) Saturdays $ 185.00

Student 1: "Tell-A-Tale Theater" (8 - 12) Saturdays $ 200.00

Student 2: "Tell-A-Tale Theater" (8 - 12) Saturdays $ 200.00

Total $ 0.00

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Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

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General Contact Information

Student Information - 1

Student Information - 2

Payment Information

Payment Information - Credit Card, Cash, Check and Tuition Assistance

Tuition Assistance Application

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