PRE REG FALL 2011

                                                                                                                            Class code__Jazz code____

       Sister Code__ ___ ___

PRE-REGISTRATION FORM FOR FALL 2011

mail to: Jill Rauscher, 18314 Barbuda Ln.

Houston,77058 or return to studio

Paper clipped with this form(check):

1. $40 fee per family ( non-refundable)

2. Self-addressed STAMPED envelope.

3. 1 completed rolodex card per family (Available at studio or approve the one on file)

4. Pre- reg, &secondary form(s) for each additional child in family& jazz(if taking extra class

NAME of STUDENT________________________(as of Sept)   AGE_______Date of Birth_______

GRADE(fall ’11)________SCHOOL________________

Dismissal time__________Home schooled_____

____Check here if enrolling more than 1 student 

Name(s)_______________________________

____extra jazz class(fill out jazz &secondary reg. Form(s)

Parent Name________________________    Phone#_______________________

Cell Phone_______________     Email_____________________________

-

Address______________________City_____________Zip__________

Last Year’s dance teacher_____________________Routine in recital__________________________

_____PLEASE REGISTER HER FOR ADDITIONAL JAZZ CLASS (might be on

diff.day $33-$38 month extra ) Fill out additional jazz pre-reg form

*This does not guarantee placement in extra jazz classunless enrolled’10-11 jazz

This will be her _____year at our studio. If past experience ____ballet____tap_

Days of school (if not 5 days a week)M___T___W___T___F___ Mornings available______________

Circle day you absolutely could not attend M TU W TH FR REASON_________________

IF EVENING CLASS IS REQUIRED, EARLIEST IF EVENING ARRIVALTIME________