SPRING 2012 Scott-Ellis School of Irish Dance Registration Form

SPRING 2012 Scott-Ellis School of Irish Dance Registration Form
First Name
Last Name
Birth Date (req'd if competing)

MonthDayYear
If dancer is a minor, please list parent(s)/guardian(s)/ or Not Applicable
E-mail
2nd Email, if you want 2 emails to get school information
Phone Number
No spaces, no dashes, no hyphens, just numbers!
Emergency Phone Number
No spaces, no dashes, no hyphens, just numbers!
Address
City
State
Zip Code
Additional Notes (including past experience, Medical Problems, etc.)
Spring 2012 Classes You Are Registering For:
After you select which individual classes to take, tally the number of hours per week TOTAL per family and use it in the second section. If you have multiple dancers in one family, use the TOTAL Hours along with registrations on the first dancer, then just add an additional registration fee on subsequent dancers.
Which Classes will this Dancer be in? Pick as many as you need to. *
Registration + Number of Class Hours Per Week For Your Family
Directions: Select One Registration Fee option for your dancer, then the correct number of hours per week for the family. If you have more than one dancer in a family, pay the full number of hours for on the form for the first dancer. For subsequent dancers, don't select hours, but still submit form/ Registration.
The FULL SEMESTER OPTION is only for those who are paying for the entire semester by check (not Paypal). Check needs to be received by January 31, 2012 to be eligible for semester discount. When selected, the information won't get added to the total sent to paypal. When you see the paypal screen, you can quit and you would pay it on your own, either by mail or in person.
Please choose all that apply
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NEW STUDENT REGISTRATION FEE$25.00

MAXIMUM NEW FAMILY REGISTRATION FEE (for siblings/parents) $50.00

45 minute classes ($53) $53.00

1 hour classes ($58) $58.00

1.25 hour classes ($68)$68.00

1.5 hr. of classes ($74)$74.00

1.75-2 hrs. of class ($84)$84.00

2.25-3 hrs. of class ($95)$95.00

3.25-4 hrs. of classes ($121)$121.00

4.25-5 hrs. of classes ($142)$142.00

5.25 - 6 hrs. of classes ($152)$152.00

6.25 - 7 hrs. of classes ($163)$163.00

7+ hours, Talk to Wendy ($0)Free

45 minute semester price $255Free

1 hr. semester price $281Free

1.25 hrs. semester price $332Free

1.5 hrs. semester price $357Free

1.75-2 hrs. semester price $408 Free

2.25-3 hrs. semester price $459Free

3.25-4 hrs. semester price $587Free

4.25-5 hrs. semester price $689Free

5.25 - 6 hrs. semester price $740Free

6.25 - 7 hrs. semester price $791Free

7+ hours, Talk to WendyFree

Total $0.00
Comments?
Reminder! Even if you are paying for these by check, please remember to fill out one of these for each dancer. Click on "Submit", then exit out when the Paypal page comes up.
Please choose how you would like to receive news about school activities
How did you hear about us?

Other
**Before you hit "Submit"** use your browser's print button to save a copy for yourself or if you want to submit it by hand. SESID prefers that you submit electronically.
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SPRING 2012 Scott-Ellis School of Irish Dance Registration Form

Spring 2012 Classes You Are Registering For:

Registration + Number of Class Hours Per Week For Your Family

Please choose all that apply*

Reminder! Even if you are paying for these by check, please remember to fill out one of these for each dancer. Click on "Submit", then exit out when the Paypal page comes up.

**Before you hit "Submit"** use your browser's print button to save a copy for yourself or if you want to submit it by hand. SESID prefers that you submit electronically.

Please choose all that apply

Before you hit "Submit" use your browser's print button to save a copy for yourself or if you want to submit it by hand. SESID prefers that you submit electronically.