AOE Dance Studio

17 North State Street

Ephrata, PA17522

717-733-4333

www.aoedance.com

2007-08 Registration Form

Please use a separate form for each student

PLEASE COMPLETE AND RETURN WITH $15.00 Registration Fee and First months tuition.

(Note: There is no registration fee for the Ballroom Class)

Make checks and/or money orders payable to: Art of Expression Dance Studio

Payment Policies:  Tuition is a flat rate per month. Tuition will be due on the first of every month.

A charge of $10.00 will be assessed if tuition is not received by the 10^thof that month. There are no refunds of registration fees.  $25 fee for returned Checks.

There are no deductions for missed classes. Make up classes will be offered.

½ to 1 hour per week                          42.00 per month

2 hours per week                                 70.00 per month

3 hours per week                                 95.00 per month

Dance Cards are available for Ballroom Tuesdays

$12 per session or $50 for a dance card which entitles you to 5 sessions

Reservations are requested for the above classes by the day prior to the class by calling the studio

733-4333 or e-mailing us at artofexpression2006@yahoo.com

Please leave your name and phone number.

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Date: __________________________  

Name of Student ______________________________________ AGE: __________ Birthdate: _______

Name of Parent or Guardian: _____________________________________________________________

Home Phone: _____________________________ Cell: _________________________________________

Address: ______________________________________________________________

City/Zip: _____________________________________________________________

Email Address: ________________________________________________________

Emergency Contact:

Name: ____________________________________ Phone: _____________________

Previous Dance Experience(Not necessary): Check one: Yes ___ No ____

If Yes, Please list______________________________________________________________________

Please the class or classes you wish to enroll in. Please include Day and time of class:

 1.______________________________________            2.__________________________________

Family Discount:

Please indicate other family members registering in order to receive family discount of $5.00 off monthly tuition

Name of Family member: __________________________________________________________________

Class Enrolled in: ______________________________________________________________________

How did you find out about us? __________________________________________________________