Online Registration for Fall 2010/Spring 2011 Classes

Please do not print this page. This page is for online registration only. If you wish to print a paper form, please click on: Registration Form.

To register online:
1. Make sure you have the following information before you start:

class title(s)
class session(s)
class day(s) of the week(s)
class fee(s)

2. Please read the payment options listed on our Registration Information page; decide which option works best for you; then calculate the payment amount due with this registration. Checks are not accepted with online registrations.

3. To start the registration process, scroll down and enter the information requested in each box below. Press the TAB key on your keyboard to go from box to box. Do NOT use the ENTER or RETURN keys or your registration will be submitted without complete information.

4. To pay for the classes you register for, you may submit your credit card information online. Or, if you prefer, you may give us your credit card information separately via phone (919.828.1713) or fax (919.833.5218) after you submit your online registration. If you pay by credit card and choose to pay for classes monthly or semi-annually, you are authorizing Arts Together to charge your credit card monthly or semi-annually.

5. When you have entered all your registration information, click the button labeled “Submit Registration to Arts Together”. If you’ve made mistakes and want to start over, click the button “Reset Form”.

6. Once Arts Together has processed your registration and payment, you will receive a confirmation letter that includes class dates and school policies.

If you have questions, call Arts Together at 919.828.1713 or send us an e-mail: info@artstogether.org

Student's Name

Date of Birth

Current Age

Male Female

Racial/Ethnic Identity or Identities (Our funding sources request this information from us.)

Father's Name

Father's Home Phone

Father's Work Phone

Father's Cell Phone

Mother's Name

Mother's Home Phone

Mother's Work Phone

Mother's Cell Phone

Student's Home Phone


August 2010 Grade


August 2010 School

Mail to Name

Mailing Address

City

Zip

E-mail Address

In case of emergency, we will call parents first. Whom should we call after or other than the parents?
Emergency Contact Person's Name

Contact Person's Home Phone

Contact Person's Work Phone

Contact Person's Cell Phone

Hospital Preference

Physician

Phone

Learning differences and/or disabilities

Medical Issues, food allergies or other concerns

Arts Together Waiver of Liability
I hereby release Arts Together, Inc., its employees, volunteers, and board members from any and all liability, cost or expense associated with any injury sustained by any member of my family while participating in the Arts Together program. I give permission to Arts Together to seek medical treatment in case of an emergency. I further give permission to use for publication, any photo in which members of my family appear. I have read and understand the Arts Together policies.

Signature (Type Name)

Class #1 - Title

Session: First Semester Second Semester Full Year

or

Workshop Session: I II III IV

Day of the Week

Fee

Class #2-Title

Session: First Semester Second Semester Full Year

or

Workshop Session: I II III IV

Day and Time

Fee

Class #3 Title

Session: First Semester Second Semester Full Year

or

Workshop Session: I II III IV

Day and Time

Fee

Class #4 - Title

Session: First Semester Second Semester Full Year

or

Workshop Session: I II III IV

Day and Time

Fee

Class #5 - Title

Session: First Semester Second Semester Full Year

or

Workshop Session: I II III IV

Day and Time

Fee

---

Total Fall 2010/Spring 2011 Class Fees: $ 

Total Fall 2010/Spring 2011 Workshop Fees:       $ 

PLEASE CALCULATE PAYMENT DUE:

One registration fee per family per school year: $25.00.

Total WORKSHOP Fees Due: $

To pay for CLASSES MONTHLY, enter total first month’s payment here: $

To pay for FULL SEMESTER, enter total semester payment here: $

To pay for CLASSES UP FRONT, enter total class fees due here: $

Please accept my tax-deductible contribution to Arts Together’s Scholarship Fund: $

TOTAL AMOUNT DUE: $

Select method of payment: Check Credit Card (If you pay by credit card and choose to pay for classes monthly or by semester, you are authorizing Arts Together to charge your credit card monthly or by semester).

Mastercard Visa Card Account#

Exp. Date

3-Digit Verification Code

Print Cardholder's Name

Signature

AMOUNT PAID:
Please charge my card in the amount of $

How did you hear about our 2010-2011 classes?

If you have made mistakes when entering information on this page and would like to start over, please click the “Reset Form” button now.

By clicking the “Submit Registration to Arts Together” button you are authorizing Arts Together, Inc. to charge your credit card the total in the AMOUNT PAID box. You also agree to all Arts Together policies as listed on this web site’s separate Registration page. The registration information entered on the current page will be sent via e-mail to Arts Together.

---

home | classes | registration | financial aid | donations | about us | contact

©2004 Arts Together, Inc.