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Fall Enrollment Form

Student Name: __________________________________Age: _______

Address: ___________________________________________________

City: ________________ Zip: __________ Home Phone: ____________

Parents' Names: _____________________________________________

Work Phone: ___________ Cell Phone: ___________

Class Choices:

Day/Time/Class: ________________________________________________________

A non-refundable enrollment fee of $15 per student with enrollment form. Classes begin Monday, August 24, 2009. Tuition is based on the August to May dance season. Tuition is due at the first dance class of each month.

Please return to Miss Micki at 10207 E. 61st Street / Tulsa, OK 74133