Student Information

Namerequired

First Name

Last Name

Genderrequired

Male

Female

Date of Birthrequired

Must contain a date in M/D/YYYY format

Grade Levelrequired

Does this student attend POPCS?required

Yes

No

Teacher's Name

Does the student attend The Zone after school care?

Yes

No

Name of school student attends

How did you hear about us?required

If other, please explain how you heard about us.

Please tell us about the student's primary custodial household.

Parent/Guardian #1 Namerequired

First Name

Last Name

Email Address

Primary Phone Numberrequired

Must contain only numbers

Parent/Guardian #2 Name (if applicable)

First Name

Last Name

Email Address

Primary Phone Number

Must contain only numbers

Emergency Contact Information

Emergency Contact Namerequired

First Name

Last Name

Relationship to Studentrequired

Emergency Contact Phone Numberrequired

Must contain only numbers

Private Lesson Information

Private Lesson Choicerequired

Student's Years of Experiencerequired

Private Lesson Lengthrequired

Payment Information

Payment Options (Choose 1)required

Current POPCS Student--Pay once per semester. You will receive an invoice in your POPCS FACTS Account.

Current POPCS Student--Pay monthly. You will receive an invoice in your POPCS FACTS Account.

Non-POPCS Student--Pay once per semester by check

Non-POPCS Student--Pay monthly by check

Important Information for Responsible Party

Please note that the annual $50 registration fee is due at the time of enrollment if paying by cash or check. For all other payment options, the registration fee will be included in your FACTS online draft. For additional information regarding The Arts School policies for private lessons, please refer to the lessons page of our website.

Please note that The Arts School reserves the right to cancel and/or deny lessons for payments not received. A $15 late fee will be added to each payment that is late.

Financial Agreementrequired

As the financially responsible party for the above student, I (we) accept the fiscal responsibility for services selected above and I (we) also accept responsibility for the punctuality and attendance at each lesson.

Enrollment Agreementrequired

I (we) have read and agree to adhere to the policies and procedures of The Arts School as outlined on this form and The Arts School website.

Signaturerequired

Must contain only letters and spaces

In This Section

The Arts School Private Lesson Enrollment

Student Information

Please tell us about the student's primary custodial household.

Emergency Contact Information

Private Lesson Information

Payment Information

Important Information for Responsible Party