BRIDGEVIEW SCHOOL OF FINE ARTS

REGISTRATION FORM FOR CHILDREN

STUDENT NAME __________________________STUDENT BIRTHDAY (required)______

PARENT NAME(S)_____________________________________________________________

STREET ADDRESS (for new students only or if changed)___________________APT#_______

CITY_____________________STATE________ZIP CODE_____________________________

CONTACT PHONE NUMBER ____________________ E-MAIL_________________________

NAME/LOCATION OF YOUR CHILD’S SCHOOL____________________________________

Is there an art program at your school? If Yes, who is your art teacher?____________________

WHICH CLASS ARE YOU ENROLLING? For Portfolio Classes, please indicate name of high school(s) or college(s) you will be applying to

Class 1:___________________________Day/Time________________Tuition_____________

Class 2:___________________________Day/Time________________Tuition_____________

Total payment enclosed: $__________

METHOD OF PAYMENT

No cash payments.

We accept Visa, MC and Discover credit cards. We do not accept American Express.

Check or Money Order (written to Bridgeview School) ____

Credit Card___ Card No:_________________________________Expiration _______

Last 3 digits of security code (on the back of credit card)______________

I would like to have a receipt from Bridgeview e-mailed to me ____ to this e-mail ____________

Please mail this form with your payment to

Bridgeview School

Attn. Lena Murray, Director

1708 Brisbane St.

Silver Spring MD 20902

For more information call the school at (718) 937-1300.

PLEASE NOTE: We encourage you to register early, before the first day of class. If you wait until the classes begin, they may be full. In such case we would have to put your child on a waiting list for the next semester.