CHILD’S NAME_________________________________________________________________________ Date of Birth_________________________
PARENTS________________________________________________________________________________________________________________
ADDRESS (Street)_________________________________________________________________________________________________________
TELEPHONE-home_________________________________ cell____________________________________ work___________________________
EMAIL ADDRESS__________________________________________________________________________________________________________
It is very important that you include an email address. We will “flash” information to our students regarding weather closings, special events,
makeup classes, etc.
Level of Kidz Muzic _______________________________________________________
Day of Week 1st choice __________________________________ 2nd choice ____________________________________
Time of Class 1st choice__________________________________ 2nd choice_____________________________________
Full Payment is due with this registration form.
Please make checks payable to Academy of Fine Arts (or "AFA").
Mail to: Academy of Fine Arts 4519 Providence Road, Charlotte, NC 28226
Payment Enclosed $_________________
IMPORTANT NOTE: There will be no refunds after January 30, 2010
SCHOLARSHIPS ARE AVAILABLE
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For office use only:
Date received__________________________________ Check #________________________ Check Amount: __________________________
Chart _______________________ Confirmation__________ Class List____________________ Invoice__________ DB___________________
| Kidz Muzic of Charlotte www.afacharlotte.org academyoffinearts@gmail.com 704-366-0199 4519 Providence Road, Charlotte, NC 28277 |
Registration
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