Get Music Academy Registration Form

00 80. 00 90. 00 70. 00 If pre-arranged with teacher DAY TIME Student 1 See fee schedule LESSON FEE 1 LESSON FEE 2 Non-refundable Registration/Use Fee Payable each term per child DISCOUNT for students enrolled in private lessons and class/ensemble 5 per class Late Fee per child If received after registration deadline August 24 2014 Library ID Card Fee optional - 1 time only TOTAL FEES Scholarship Contribution Optional TOTAL AMOUNT PAID Cash MasterCard Visa Discover Check Credit Card Number / / / Print Cardholder s Name Expiration Date / Cardholder s Signature Except in case of extreme circumstances refunds of tuition charges will not be made after the second class meeting or private lesson. Please make a copy for your records and allow four to six weeks for payment processing. Credit card payment only FAX to 707-826-3528 HSU Music Dept. office Rec d by Make check payable mail to Humboldt Music Academy HSU Music Dept. 1 Harpst St. Arcata CA 95521 HSU is an AA/EO Title IX Institution RESET FORM. HUMBOLDT MUSIC ACADEMY FALL 2014 Student 1 Name Birthdate Age Parent/Guardian Name Address City Zip Home phone Cell Work E-mail YES Please add me to the HMA email list CLASSES ENSEMBLES Saturdays 10 00-10 30 10 30-11 00 11 00-12 00 12 00-1 15 9 00-9 30 9 30-10 15 10 15-11 00 9 30-10 00 12 15-1 15 Singing Games ages 2-4 Introduction to Musical Theater ages 4 5 Musical Theater ages 6-8 Advanced Musical Theater IA Academy Fiddlers Level 1 Orff I Flute Choir Vocal Ensemble Jazz Ensemble Instrument Junior Orchestra Instrument HMA Lab Ensemble PRIVATE INSTRUCTION INSTRUMENT 30/45/60 min* INSTRUCTOR LENGTH Fee 60. 00 80. 00 90. 00 70. 00 If pre-arranged with teacher DAY TIME Student 1 See fee schedule LESSON FEE 1 LESSON FEE 2 Non-refundable Registration/Use Fee Payable each term per child DISCOUNT for students enrolled in private lessons and class/ensemble 5 per class Late Fee per child If received after registration deadline August 24 2014 Library ID Card Fee optional - 1 time only TOTAL FEES Scholarship Contribution Optional TOTAL AMOUNT PAID Cash MasterCard Visa Discover Check Credit Card Number / / / Print Cardholder s Name Expiration Date / Cardholder s Signature Except in case of extreme circumstances refunds of tuition charges will not be made after the second class meeting or private lesson* Please make a copy for your records and allow four to six weeks for payment processing* Credit card payment only FAX to 707-826-3528 HSU Music Dept. office Rec d by Make check payable mail to Humboldt Music Academy HSU Music Dept. 1 Harpst St* Arcata CA 95521 HSU is an AA/EO Title IX Institution RESET FORM. HUMBOLDT MUSIC ACADEMY FALL 2014 Student 1 Name Birthdate Age Parent/Guardian Name Address City Zip Home phone Cell Work E-mail YES Please add me to the HMA email list CLASSES ENSEMBLES Saturdays 10 00-10 30 10 30-11 00 11 00-12 00 12 00-1 15 9 00-9 30 9 30-10 15 10 15-11 00 9 30-10 00 12 15-1 15 Singing Games ages 2-4 Introduction to Musical Theater ages 4 5 Musical Theater ages 6-8 Advanced Musical Theater IA Academy Fiddlers Level 1 Orff I Flute Choir Vocal Ensemble Jazz Ensemble Instrument Junior Orchestra Instrument HMA Lab Ensemble PRIVATE INSTRUCTION INSTRUMENT 30/45/60 min* INSTRUCTOR LENGTH Fee 60. 00 80. 00 90. 00 70. 00 If pre-arranged with teacher DAY TIME Student 1 See fee schedule LESSON FEE 1 LESSON FEE 2 Non-refundable Registration/Use Fee Payable each term per child DISCOUNT for students enrolled in private lessons and class/ensemble 5 per class Late Fee per child If received after registration deadline August 24 2014 Library ID Card Fee optional - 1 time only TOTAL FEES Scholarship Contribution Optional TOTAL AMOUNT PAID Cash MasterCard Visa Discover Check Credit Card Number / / / Print Cardholder s Name Expiration Date / Cardholder s Signature Except in case of extreme circumstances refunds of tuition charges will not be made after the second class meeting or private lesson* Please make a copy for your records and allow four to six weeks for payment processing* Credit card payment only FAX to 707-826-3528 HSU Music Dept.