NAME_____________________________________DOB_______________
ADDRESS_____________________________________________________
TELEPHONE: ______________ HOME _____________ WORK _________CELL
E-mail ______________________________
COMPETITIVE STANDING (for competing dancers only) Beg._____ Nov. Int. Prem. (Indicate number of stamps for Beginner and Novice.) FUSTA Registration #___________
A Class consists of 5-6 dancers. Smaller groups are Semi - Private Lessons.
COUNTRY/CEILIDH: 1 1/2 hour class - SPECIAL FAMILY & HIGHLAND DANCER RATES
CASUAL RATES ARE DESIGNED FOR COLLEGE GIRLS & VISITING DANCERS - NOT STUDENTS ENROLLED FOR THE YEAR: By special arrangement only.
CLASSES: MON___________TUES.__________WED_________ THURS._________OTHER_________
FIRST MONTH=S TUITION $_____
ANNUAL REGISTRATION FEE (if not paid during summer) $15 00
CHECKS PAYABLE TO ELEANOR UNGER INC. TOTAL $
I understand I am enrolling for a 11 month school year (September - July) based on 44 weeks of the year which averages 4 classes monthly. Monthly tuition is due on the first week of each month or a $15 late fee is added. All Students must complete annual Registration Forms. A drop out form must be completed 1 month prior to withdrawing from school1 months tuition will be charged. An advanced payment system of 3 payments with 5% discount is available upon request.
Signed __________________________ (Parent if under 18) Date_____