Faculty Teacher

30 minute lesson                          8 payments of $116.25................. $465         

45 minute lesson                          8 payments of $145.00................. $580

60 minute lesson                          8 payments of $167.50................. $670                                                          

 

Graduate Teacher

30 minute lesson                          8 payments of $103.75................. $415

45 minute lesson                          8 payments of $118.00................. $472         

60 minute lesson                          8 payments of $144.25................. $577         

                                                

 

 

I agree to abide by the SIUE Suzuki Policies for the year 2008-2009.

 

___________________________

  Parent Signature
Text Box: Length of Lesson (circle one) 30 min 45 min 60 min Annual Registration Fee (due at time of registration): $20/student or $30/family $__________________ Tuition Fee Per Semester: (see chart below) $__________________ o Credit Card (requires separate form) o Check (payable to SIUE) o Cash SIUE Parking Hangtag: $20 $__________________ Good from Aug - May for the current academic year (hangtags CANNOT be ordered until vehicle information is COMPLETE) Vehicle Info: Make_______________ Model________________ License Plate # ____________________State ______________ Total Due for Fall Semester 2006: First Payment to secure registration Date___________ Amount___________ (Registration Fee and One Tuition Payment Required – due by August 15, 2007)

BRING TO OFFICE OR MAIL TO: 

SIUE SUZUKI STIRNGS PROGRAM

Box 1771, Edwardsville, IL 62026     618.650.2839     

Student Name __________________________________

Instrument____________ Teacher __________________

Age____________ Birthdate _______Year Started ___________

Mother's Name_____________SSN _______________________

Father's Name _____________SSN _____________________

Address (Street) _______________________________________

(City) (State) (Zip) ______________________________________

Home Phone ____________ Pager or Cell Phone ____________

Email (for payment reminder) _____________________________

Mother's Work # ____________Father's Work #______________

Other contact person______________Phone _______________

 

 

 

 

 

 

 

 

 

 

 

 

                                                   

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2008-2009 Registration Form