VIVETTE’S DANCE STUDIO
1102 Armory Rd
Salina, Ks 67401
785-827-3396
vivettesdance@hotmail.com
____________________ ___________________ ______/_______/_____
Student’s LAST Name Student’s FIRST Name Date of Birth
____________________ ___________________ ___________________
Address City Zip Code
_____________________ ________ _________
____________________________
Parent’s/Guardians Name(s) Home # Work/Cell# other # E-Mail
Address
School____________ Circle ’10-’11 grade Pre-K, K, 1,2,3,4,5,6,7,8,9,10,11,12,Adult
If you are a new student, who were you referred by? _________________________
You can receive a Referral Bonus of $8.00 to your account per dancer you refer!
__________________________________________________________________________
__________________
FALL ENROLLMENT PICK YOUR CLASS FORM
Please pick your class and time and indicate on the form below, and return to Miss Vivette as
soon as possible.
Please include your registration fee of $10.00 per dancer or $15.00 per family.
*If you have already paid when you turned in the pre-enrollment form, no worries, we’ve got it.
______________________________ would like to be in the following classes
Subject Day Time Grade Comments
If we do not currently have a class time that works for you please indicate what you would like.
We’ll contact you if we make that change.
1102 Armory Rd
Salina, Ks 67401
785-827-3396
vivettesdance@hotmail.com
____________________ ___________________ ______/_______/_____
Student’s LAST Name Student’s FIRST Name Date of Birth
____________________ ___________________ ___________________
Address City Zip Code
_____________________ ________ _________
____________________________
Parent’s/Guardians Name(s) Home # Work/Cell# other # E-Mail
Address
School____________ Circle ’10-’11 grade Pre-K, K, 1,2,3,4,5,6,7,8,9,10,11,12,Adult
If you are a new student, who were you referred by? _________________________
You can receive a Referral Bonus of $8.00 to your account per dancer you refer!
__________________________________________________________________________
__________________
FALL ENROLLMENT PICK YOUR CLASS FORM
Please pick your class and time and indicate on the form below, and return to Miss Vivette as
soon as possible.
Please include your registration fee of $10.00 per dancer or $15.00 per family.
*If you have already paid when you turned in the pre-enrollment form, no worries, we’ve got it.
______________________________ would like to be in the following classes
Subject Day Time Grade Comments
If we do not currently have a class time that works for you please indicate what you would like.
We’ll contact you if we make that change.
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