Dance Class Registration Form

Your 3 Steps away from Dancing yourself to.... a Happier way of Life!

Please register one student at a time.
Step 1. Student Information
Student Name:         Student Date of Birth (child dancers):
Parent/Guardian Name:       Email address:
Address 1:      Address 2:

City:     State:       Zip Code:

Phone:       Best time to call?  Morning Noon Evening
 
Step 2. Class Selection

Your first month’s lesson fee is due at registration to reserve your spot in class! Registration is non-refundable and non-transferable.

Step 3.  Review your information - click - submit.  All sections of the form must be filled out to be submitted.

Or you may Call: 517-712-5887

Mail Payments to:

Platinum Dance Academy

4976 1/2 Northwind Dr.

East Lansing, MI

48823

Thank You! Shelley  

                                                

Last modified: February 06, 2013    The forms processing software supplied by www.tectite.com.