REGISTRATION FORM / STUDENT CONTRACT

 Name: Age: 
Address:
             

Phone

Level: Novice Intermediate Advanced I would like to take: Both Classes Scene/Monologue Class On Camera Class

DAYS: SAT 2 TO 5 PM            SUN 1 TO 4 PM

MON 6:30 TO 9:30 PMTHURS 6:30 TO 9:30 PM FRI 6:30 TO 9:30 PM  

START DATE: 

MONTH   DAY YEAR

  I WILL SEND MY PAYMENT IN FULL ($750.00 PER 3-MONTH COURSE)

 I WILL SEND A $350.00 DEPOSIT PER COURSE AND MAKE $100.00 PAYMENTS PER CLASS UNTIL BALANCE IS PAID  

Signature:_______________________________________

MAKE CHECKS PAYABLE TO: CHARLES ASCELLO

AND SEND TO: 4285 George Avenue #3    SAN MATEO, CA   94403

If you desire print out completed order form and either mail, or bring it to the first class.  First Class is FREE, with NO OBLIGATION.