STAGES! Conservatory
STUDENT APPLICATION FOR AGES 13-17

STAGES! - Mondays & Wednesdays 4pm - 6pm

TUITION RATE: The semester-long program pricing: $650

PAYMENT SCHEDULE
$100 deposit (with registration) Payment #1
$250 due by October 2nd (first day of class) Payment #2
$300 due by November 22 Final Payment

We offer a 15% sibling discount

$100 class deposit may be made via our PayPal registration on www.arthouseproductions.org, or mail check/money order along with this form to:

ART HOUSE PRODUCTIONS
P.O. Box 3264
Jersey City, NJ 07303

Participant's Full Name *
Your answer
Is there a sibling participating in STAGES or STAGES Jr? If so, please list their name(s).
Your answer
Gender Identity *
Required
Date of Birth *
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DD
/
YYYY
Age as of October 2017 *
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Street Address *
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City / State *
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Zip *
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Parent (s) Name *
Your answer
Parent(s) Email Address: *
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Contact # *
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Student's Email Address (If Authorized) *
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Emergency Contact Name *
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Emergency Contact Phone # *
Your answer
Does your child have permission to walk home alone?
If you answered "No" to the previous question - Please list the names of the Adult(s) Authorized to pick up your child.
Your answer
Is there anyone who is NOT Authorized to pick up your child?
Your answer
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