Raeann School of Dance Inc.

...THE TRADITION CONTINUES

FALL REGISTRATION

2010-2011  Registration

DEADLINE FOR EARLY REGISTRATION - JUNE 30, 2010 FOR 2010-2011 CLASSES

Student’s Name_______________________________ Age __________

Birthday ______________

Parent’s Name ___________________________________________________________  

Address ___________________________________ Telephone - home ___________________

                                      Work ________________________

                                      Cell _________________________

City _____________________________ State________ Zip____________________

e-mail address: ______________________________________________________________

CLASSES REQUESTED       ________________________________________

                       ________________________________________

WOULD A MORNING CLASS BE POSSIBLE___________________

AFTERNOON CLASSES ARE SCHEDULED FROM 3:30 ON.  WHAT IS THE EARLIEST TIME YOU

CAN MAKE A CLASS ________________________

LIST ANY DAY YOU CANNOT ATTEND CLASS__________________

REGISTRATION FEE $10.00 PLEASE CHECK:      CASH ____________ INCLUDED

   Before June 30:   $10.00

   After June 30:      $15.00               CHECK __________ INCLUDED

IS THIS A FAMILY REGISTRATION FEE? ______________

CHECK STUDIO:     KEOKUK _______

CARTHAGE _______

                    KAHOKA _______

EARLY REGISTRATION DEADLINE - JUNE 30, 2010

*AFTER JUNE 30, REGISTRATION FEE $15.00

FEES - ½ hr. class ...   $18.00         1 hr. class ... $35.00

             Semi-private ... $36.00        Private ...       $52.00   

        For any questions or further information please contact us:

                      Studio ... 319-524-2307  raeann@raeannschoolofdance.com

              www.raeannschoolofdance.com

Registration may be mailed to .......        Raeann School of Dance Inc.

                                                  615 Blondeau Street

                                             Keokuk, Iowa 52632