Tutti Registration Form Fall 2018

Child's Name *

First Name Last Name

Child's Date of Birth *

Date

Grade 2018-19 *

School 2018-19

Please briefly describe your child's special needs *

Parent 1 Name *

First Name Last Name

Parent 1 Phone Number: *

- Area Code Phone Number

Parent 1 E-mail *

Parent 1 Address *

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

Parent 2 Name

First Name Last Name

Parent 2 Phone Number

- Area Code Phone Number

Parent 2 E-mail

Parent 2 Address (if different than Parent 1 address):

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

Emergency Contact Name *

First Name Last Name

Emergency Contact Phone *

- Area Code Phone Number

Emergency Contact Relation to Student *

How did you hear about Tutti Choir? *

I agree to have my information included in the Tucson Girls Chorus Directory (for internal purposes only) Please click here to read full description.

*

Yes, my information can be included in the TGC Directory No, please do not include my information in the TGC Directory

I agree to the terms of the Tucson Girls Chorus General Model Release Form. Please click here to read full description.

*

Yes, I agree to the terms of the TGC General Model Release Form No, I do not agree to the terms of the TGC General Model Release Form. Please do not use photographs of my child.

Demographic Information and Annual Household Income

Demographic information is requested by Tucson Girls Chorus in order to provide information for Grant purposes.
You are not required to furnish this information, but are encouraged to do so. All information will remain confidential.

Race/Ethnic Group

African American Native American/Alaskan Native Caucasian Hispanic/Latino I do not wish to furnish this information

Annual Household Income

Please check the box that applies to your family size:

Family Size

Family Size of 1

$0 - $16,350 $16,351 - $27,250 $27,251 - $41,700 Greater than $41,701

Family Size of 2

$0 - $18,700 $18,701 - $31,150 $27,251 - $41,700 Greater than $41,701

Family Size of 3

$0 - $21,050 $21,051 - $35,050 $35,051 - $53,650 Greater than $53,651

Family Size of 4

$0 - $23,350 $23,350 - $38,950 $38,951 - $59,600 Greater than $59,601

Family Size of 5

$0 - $25,250 $25,251 - $42,050 $42,051 - $64,350 Greater than $64,351

Family Size of 6

$0 - $27,100 $27,101 - $45,200 $45,201 - $69,150 Greater than $69,151

Family Size of 7

$0 - $29,000 $29,001 - $48,300 $48,301 - $73,900 Greater than $69,151

Family Size of 8

$0 - $30,850 $30,851 - $51,400 $51,401 - $78,650 Greater than $78,651

_________________________________________________________________________________

Tuition scholarships available and accepting ESA funds. Inquire with TGC staff for application and ESA payment processing.

Registration Fee *

One-time registration fee $25.00

Tuition *

Tutti Choir (February 27-May 8) $100.00 I will apply for tuition assistance $20.00 I will pay $20 now and pay the remainder with ESA funding

Payment Type *

I will pay by credit card and pay a convenience fee (2.5%) I will pay by check and either deliver it to TGC or mail it to TGC. Please include "Tutti Choir" in the memo field

Convenience Fee

SubTotal

Codes

Other Codes

Open House discount

other discount

Total Payment

My Products

USD Description

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

Please contact us with any questions.

jedelbrock@tucsongirlschorus.org or 520-577-6064

Tucson Girls Chorus Tutti Choir Registration