ABSS School of Fine Arts
Dr. Jon Hynes, Director
62 Pleasant Valley Drive
Little Rock, AR  72212



2011-2012 PRIVATE AND SEMI-PRIVATE 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 like.
Private lessons are $120 per month; semi-private lessons are $60 per month per child.






      


***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
                                                                        LESSONS BEGIN MONDAY, AUGUST 29, 2011
EACH COURSE HAS 30 LESSONS AND FOLLOWS THE SAME HOLIDAY SCHEDULE AS GROUP INSTRUCTION
    BOOKS AND MATERIALS ARE NOT INCLUDED


                             Billing Zip Code*:
Private   Semi-Private (Enter name of your partner if you have one.)
Piano
Orchestral Instrument
Band Instrument
Guitar
Voice
Music Theory/Composition
Art
Charge my card this one time only.       Automatically charge my card each month.