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Conservatory of Music and Dance

Registration for one Student

Name of Student School Department

Registration for Two Students or a Family

Family(two or more enrolled)  last name School Department

Tuition Payment in $1.00 increments.  Example:  If you are paying $42.00 enter "42" below.  If you are paying $162.00 enter "162."  You will see your entry on the next page when you Click on "Add to Cart"

Total payment (ex. enter 33 for 33.00) Name of student School Paying for
COMPETITION PAYMENTS(Choreography and Music)
Music Competition
Number of entries Students Name Students Teacher School

Choreography Competition

Name of Student School Title of Dance

SUMMER REGISTRATION  $25.00 fee to be subtracted from the cost of the program(non refundable)

Name of Student School Enrolling in