Studio C
Online Enrollment Form
The information in this form will be sent to Studio C over a SECURE Internet Connection.
We will not share this information with anyone outside of our company.

Parents Name if any student is under the age of 18 (first & last)

Contact Information

Address City State Zip
       
Home Phone Work Phone Cell Phone E-mail
   

2017 - 2018 Class Schedule
Class Schedule & Tuition will open in a new window so you can refer to them while filling out the enrollment form.

1st Students Name
(first & last)
 
Birth Date
Grade Level
Enter your class selection below
2nd Students Name
(first & last)
 
Birth Date
Grade Level
Enter your class selection below
3rd Students Name
(first & last)
 
Birth Date
Grade Level
Enter your class selection below
4th Students Name
(first & last)
 
Birth Date
Grade Level
Enter your class selection below

List Classes Selected

 

REQUIRED
Payment Options

Debit Card
VISA Card #
        Exp. Date
 
MasterCard Card #
        Exp. Date

 

Card Holders Name

Billing Address

City

State

Zip Code


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Release of Liability Disclaimer.
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