AAHP: Student Information Update Form

Academy of Art of Highland Park & Gallery Inc. (AAHP)

727 Raritan Avenue, Highland Park, NJ 08904 USA

www.aahpnj.com (732)-777-2085

Student Information Update Form
2019 - 20 School Year

Please use this form to update account information for any currently enrolled student.

Student Information

Student Name*

First NameLast Name

Is Student Under 18?*

Name of Representative responsible for tuition and other charges*

First NameLast Name

I would like to submit... (check all that apply)

Email Address Update

New Email*

Phone Number Update

New Phone Number Type*

Phone Number*

Street Address Update

New Street Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Emergency Contact Information Update

My CURRENT emergency contact's name is...*

First NameLast Name

I would like to...

My CURRENT Emergency Contact's NEW Phone Number is...*

My NEW Emergency Contact's Name is...*

First NameLast Name

My NEW Emergency Contact's Phone Number is...*

My ADDITIONAL Emergency Contact's Name is...*

First NameLast Name

My ADDITIONAL Emergency Contact's Phone Number is...*

Returning to Class After Temporary Discontinuation

The last Session I attended was...

Year of Attendance (i.e. 2018)*

I wish to return for...*

I would like to...*

Course Selection Update

I currently take classes on...*

My CURRENT Class Duration Is...

My DESIRED new class slot is...*

My DESIRED class duration is (if you would not like to change your class duration please mark the same amount as your CURRENT duration here)*

Credit/Debit Card Update

Please note that the system will not register new card information without a charge. For this reason, you will temporarily billed a $0.50 charge so that your change will register. Once the change is processed, you will be refunded that $0.50 in full. Thank you.

Please ensure that all billing information matches credit card information.

Please no spaces or dashes when entering you credit card number.

My Products*

Refundable Transaction Fee$0.50

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Other

Other changes*