Jill Listi Dance Studio

student application

2010 - 2011 SCHEDULE

Miss Jill's Class Page

HOIDAY SCHEDULE

INCLEMENT WEATHER NOTICE !!!

Miss Cathy's Class Page

Miss Jenny's Class Page

Miss Kim's Class Page

Miss Michelle's Class Page

Miss Kelly's Class

SUMMER CAMPS

SUMMER INTENSIVE

SUMMER BALLET INTNESIVE

ADULT Ballet/Pilates

Miss Natalie's Class

Miss Jennifer's Class

Miss Stephanie's class

PRIVATE LESSONS

student application

Please complete this form to register for classes at Jill Listi Dance Studio. The information on this form will be used to assess the student's placement and class level. We will contact you upon receipt of this document. Visa, MasterCard or DiscoverCard information must accompany your application. Please include credit card #, expiration date and 3 digit security code from the signature panel on the reverse side of the card in the COMMENT box located at the end of this form. YOUR REGISTRATION IS NOT VALID & WILL NOT BE PROCESSED IF YOUR CREDIT CARD INFORMATION IS NOT SUBMITTED WITH YOUR FORM.(REGISTRATION FEES ARE NON-REFUNDABLE)

Registration Fees:

$90.00 Child/$150.00 Family (returning & new students)

If you are Registering for the SUMMER INTENSIVE, SUMMER CAMPS, BALLET INTENSIVE, Adult Ballet/Pilates or Teachers Training Courses, please indicate this in the comment box located at the bottom of this form..thank you!!

Please note: If you are transfering from another studio, please let us know how many years of dancing you have completed as well as any Teachers Training Courses (DMA certified) you may have passed. All of your training will transfer to our studio for awards as well as Graduation requirements.

E-Mail Address

Student`s Name

Age

Birthdate

School

Grade

Parent`s Name

Address

Home Phone

Work Phone

Cell Phone

Previous Teachers

Please note: If you are transfering from another studio, please let us know how many years of dancing you have completed as well as any Teachers Training Courses you may have passed. All of your training will transfer to our studio for awards as well as Graduation requirements.

Years of Dance Training Completed

Please tell us what classes you are registering for:

~Tap, Jazz & Ballet (single combination class til age 11)

~Tap, Jazz & Ballet (tap & jazz on 1 night, ballet on separate night

(this is for students 12 & over)

~Hip Hop (as an ONLY class) ~Hip Hop (in addition to other classes)

~Ballet (as an ONLY class) ~Ballet(in addition to regular classes)

~Turns & Leaps (as an ONLY class) ~Turns & Leaps (in addition to regular classes)

~Technique (as an ONLY class) ~Technique (in addition to other class)

~SUMMER CAMP or Summer Classes ~Summer Intensive with WCDE instructors

~SUMMER Ballet Intensive

~Summer Adult Ballet/Pilates ADD CREDIT CARD INFORMATION IN BOX BELOW

Comments

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