REGISTRATION / RENEWAL FORM
     
 
Name:
  
 
 
 
Date of Birth:
  
 
 
 
Contact Information:
  
Same as before
 
(please select one)
 
See info below
     
 
Home Phone:
  
 
Cell Phone:
  
 
Email:
  
 
Street Address:
  
 
City:
  
 
Province:
  
 
Postal Code:
  
     
 
Union:
  
Actra
 
(please select one)
 
Equity
 
 
Non-Union
 
 
 
Class of Interest:
  
 
Day & Time:
  
 
Teacher:
  
 
 
 
I'm a Returning Student:
  
 
Previous Class:
  
 
Date:
  
 
 
 
Agent:
  
 
 
 
Payment Method Preferrred:
  
Cheque
     
Online Credit Card
       
 
At this time I prefer to pay:
  
Deposit Only
     
The Full Amount
 
 
 
I understand that the $100 deposit is a non-refundable fee
   
 
NOTE: If you have made the selection above to pay online, we will email you a "digital invoice" with instructions on how to make your payment. We use PayPal and can accept Visa, MasterCard and American Express.
 

SPAM PREVENTION

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