Julie-ann Lucas

School of Dance

ENROLMENT FORM 2009

STUDENTS NAME – _________________________________________

PARENTS NAME – __________________________________________

ADDRESS – _______________________________________________

___________________________POST CODE ___________

NAME FOR INVOICE –________________________________________

HOME PHONE –____________________________________________

STUDENTS MOBILE –________________________________________

PARENTS MOBILE –_________________________________________

DATE OF BIRTH –___________________________________________

EMAIL ADDRESS –__________________________________________

Do you want your newsletters, notes etc via email YES / NO (please circle)

CLASSES- Please indicate classes required including grade and day if known.

BALLET- _____________TAP-________________ JAZZ-_____________

THEATRICAL-_________ TINIES______________ PRE-SCHOOL_______

MUSICAL TH-__________ACRO_______________ EISTEDDFOD_______

OTHER____________________________________________________

NEW STUDENTS:

Any Previous Training –_________________________________________

Any Previous Exams – __________________________________________

_________________________________

OFFICE ONLY:

Details Update: MYOB Access Outlook Roll Pigeon Hole #____

Cancelled: MYOB Access Outlook Roll Pigeon Hole #____