registration form. - Community School of Music and Arts

SPRING 2013 REGISTRATION
CLASSES, CAMPS & WORKSHOPS
CONTACT INFORMATION – one student per form
Student’s Name Parent/Guardian Name 1
Home Address Cell Phone Work Phone
City State Zip Employer
Home Phone Parent/Guardian Name 2
Cell Phone Work Phone Cell Phone Work Phone
Email
Employer
Birthdate Emergency Contact Emergency Phone
School Presently Attending/Employer
Does your child have special needs (Please specify)
COURSE REGISTRATION
❶ If registering for an Ensemble, please include the instrument name. ❷ Camp students: Be sure to register for extended day supervision.
❸ CSMA private music lesson students registering for Core Curriculum classes should clearly mark tuition box: $0/CC
1.
2.
3.
4.
5.
6.
COURSE NUMBER COURSE TITLE TUITION/FEE
PAYMENT
Payment IN FULL is due with registration. Checks payable to CSMA.
DISCOUNTS I am eligible for: family multiple classes senior (55+)
AMEX
Visa/MC
Print Cardholder Name
/
Card Number Exp. Date Security code
Cardholder signature
By checking this box, I authorize CSMA to accept my printed name as my signature on this
form only (for submitting via email).
POLICY AGREEMENT
I have read and agree to all CSMA policies.
Signature
Your registration cannot be processed without a signed policy agreement.
CSMA may use any photographs, video, or artwork of
me or my child in CSMA publications and on the web.
Yes No
OFFICE USE ONLY
Tuition/Fee: $
Adjustments: $
Tax-deductible
donation: $
Total Amount Due: $
My company will match my
donation.
To donate online, go to
www.arts4all.org.
ETHNICITY (OPTIONAL)
HOW DID YOU HEAR ABOUT CSMA
Native American Asian/Pacific Islander Neighbor or Friend Banner Media Article
African-American Hispanic/Latino Library or Rec Center Website Yellow Pages
Middle Eastern European American Advertisement Catalog Insert in Newspaper
Other Not Disclosed At My School (Teacher/Newsletter) Other:
Community School of Music and Arts | 230 San Antonio Circle | Mountain View, CA 94040 | 650.917.6800 | fax 650.917.6803 | www.arts4all.org

SPRING 2013 REGISTRATION
POLICIES FOR CLASSES/CAMPS/WORKSHOPS
REGISTRATION DEADLINE
Because many classes, camps and workshops fill up quickly, we strongly encourage students to enroll at least two weeks prior to the
starting date.
After the first class/camp, enrollments are accepted on a space-available basis only and are also subject to instructor/program
director approval. Tuition can be pro-rated for late enrollments approved after the first class.
PAYMENT INFORMATION / FINANCIAL AID
CSMA charges a non-refundable registration fee of $10 per class/camp/workshop, which is included in the tuition cost. Students
register for a full semester and payment in full is required at the time of registration.
In keeping with our mission of making the arts accessible to all, financial aid is offered to qualifying students. Please see our Student
Services Office for further information.
DISCOUNTS
A 10% discount will be applied to the lesser tuition for additional family members. Seniors (55+) will receive a 15% discount with
proof of age. Only one type of discount per registration will be applied.
WAIT LIST POLICY
Registrations are processed in the order received. In some cases, students may be waitlisted due to enrollment limits. There is no
charge for this service. Your online shopping cart will indicate if a class is waitlisted; staff will individually contact students using
other registration methods. You will only be contacted again should a space become available.
REQUESTS FOR CLASS TRANSFERS
Students may apply for one class transfer per semester by submitting the Request for Class Transfer form. Requests are subject to
space availability and program coordinator approval. All requests must be received within three business days after the second
class. After that, no transfers or refunds will be approved.
ABSENCES
Missed classes/camps/workshops due to a student’s absence are not made up. As a courtesy to your teacher, please notify your
teacher in advance about any lessons you will miss. If a class is missed due to a teacher’s absence, a make-up class will be scheduled.
In cases of emergency or serious illness, a leave of absence may be requested. All requests must be accompanied by a doctor’s note
and made in writing to the Student Services Office. If approved, credit may be given for those absences.
PHOTO RELEASE POLICY
From time to time CSMA takes photographs of students and/or artwork for possible use in our publications and exhibits and for
funding, development, and public relations purposes. Your privacy is important to us, so we have included a check box on the
registration form requesting your permission to use such images in the manner described above. No compensation is provided to
individuals who appear in the photographs or for the artwork used.
IMPORTANT – CHILD SAFETY
To ensure your child’s safety, please be sure to pick him/her up promptly after class time. Children are under supervision only during
their scheduled class time; teachers and administrative staff are not able to supervise children outside of teaching time.
All forms can be found on our website: http://arts4all.org/register/forms.htm.
Community School of Music and Arts | 230 San Antonio Circle | Mountain View, CA 94040 | 650.917.6800 | fax 650.917.6803 | www.arts4all.org