Term 1 2018        
MONDAY 3.45 – 4.15 $82
4.15 – 4.45 $82
4.45 – 5.15 $82
5.15 – 6.00 $98
6.00 – 6.45 $98
6.45 – 7.30 $98
7.30 – 8.15 Open Jazz/Contemporary (12+ yrs) $98
STUDENT DETAILS
First name
Last name
Age
Parent name/s
Postal address
Postcode
Telephone (mobile preferred)
Email address
Additonal comments
PAYMENT DETAILS
(if Visa or MasterCard not provided then an invoice will be emailed to you instead)
Card type
Name on card
Card number
Expiry date (mm/yy)
CCV Number

AMOUNT BEING PAID
($25 deposit per class OR full amount)
Discounts apply until 31/12/17