Jane Whitt's Dance Studio
                                                                Enrollment Form
                                                                      2014-2015
 
 
Student Name   _____________________________________________________________________
 
 
 
Address  __________________________________________________________________________
 
 
City _________________________           Zip ______________                   Phone ____________________
 
 
Birthdate ______/_______/_______          Grade-Fall 2014 _______                School ___________________
 
 
Parent/Guardian Name  __________________________________________________
 
 
Best Phone _____________________            Email_______________ ____________________________
 
 
 
A non-refundable $20.00 fee is due at time of enrollment.  Once this form is received at the studio, you will be given the Enrollment Contract for your child which contains specific information regarding class times and fees.