ABSS School of Fine Arts

Dr. Jon Hynes, Director

62 Pleasant Valley Drive

Little Rock, AR  72212

Tel:  (501) 227-7077

E-mail:  BeauxArts8@sbcglobal.net

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:_______________     Zip code:_______   E-mail:______________________________

***There is no registration fee.***

Payment for First Month Enclosed ($50 per course)  ____Yes        ____No

Checks for all classes should be made payable to “Fine Arts.”

Please note that space is guaranteed only with payment, and it is non-refundable.

Day and Time Preferred:      (1)__________________________________________________

There is limited space         (2)__________________________________________________

  for classes that meet      (3)__________________________________________________

during the lunch/recess block.

Check as many classes as you would like (each course is $50 per month):

□Piano     □Orchestra (________________)    □Band Instrument (__________________)

                               Please specify instrument.         Please specify instrument.

□Voice    □Theory/Composition   □Art    □Interior Design    □Culinary Arts     □French

Signature of Parent/Guardian______________________________    Date____________ 

For Office Use    CLASSES BEGIN MONDAY, AUGUST 29

Check Number_______________EACH CLASS HAS 30 LESSONS

Date_______________________

Amount_____________________