ABSS School of Fine Arts
Dr. Jon Hynes, Director
62 Pleasant Valley Drive
Little Rock, AR 72212
***Please Read and Respond to the Terms and Conditions Below Before Completing the Application***
2011-2012 REGISTRATION
Student's Name:
Student’s School: Grade in September 2011:
Parent’s/Guardian’s Name:
Home Phone: Cell Phone: Work Phone:
Street Address:
City: State: Zip code:
E-Mail:
Day and Time Preferred: (1) (2) (3)
Classes meeting during the lunch/recess block are only available to ABSS Elementary Students and home schoolers.
Check as many courses as you would like (each class is $50 per month):
***There is no registration fee.***
Please note that space is guaranteed only with the first month's payment, and it is non-refundable.
For your convenience we accept Visa, MasterCard, Discover, and American Express.
Select Credit Card* Amount to be charged*:
Enter 16 digit account number including spaces*. Expiration Month*: Year*: Name exactly as it appears on card*: Click the Submit Button Below to Submit Application
*Required Field Necessary to Secure Place
CLASSES BEGIN MONDAY, AUGUST 29, 2011
EACH CLASS HAS 30 LESSONS Billing Zip Code:
