registration form summer 2012 side 2 Class/Camp


A. Total Tuition Due: or


50% Non-refundable Camp Deposit: (full tuition due if mailed after 6/1) B. 10% Discount for Members at the Contributor level or above ($100+) C. Add or renew a Flynn Membership at the following level:


❏ Contributor ($100-$149) ❏ Sustainer ($250-$499) D. After-camp care until 5 pm at $15/day (Monday-Thursday only)


❏ Supporter ($150-$249)


Indicate days and weeks needed and add total after-camp care cost E. I’d like to donate to the FlynnArts scholarship fund


to help make arts experiences accessible to everyone! F. (A minus B, plus C, plus D, plus E, plus F) =


PAYMENT: I understand that full camp tuition is due 6/1. Please


Today’s Payment: ❏Check payable to FLYNN CENTER


Total Enclosed: $ ____________ ❏charge my card on 6/1 or ❏VISA ❏Mastercard ❏expect my check. ❏American Express ❏Discover


Card # ________________________________ Expiration Date ________ Security Code ________ Name on Card __________________________________________________________________ Signature ______________________________________________________________________


❏ I am applying for a partial scholarship in the amount of $_______ and have enclosed my 25% deposit and a description of my financial situation. Note: Apply by May 21 for best chances. After that, less funds will be available.


(Members can register early, and members at $100+ get 10% off classes and camps.) ❏ Friend ($45-$99)


+$ ____________ +$ ____________ Day/Time


Please fill out both sides completely


Tuition


$ ____________


$ ____________ -$ ____________ +$ ____________


❏ I’d like a payment plan and have enclosed my 50% deposit. Please expect my checks or charge my credit card the remaining 25% installments on June 1 and July 1. I understand that submitting this form makes me responsible for


the full tuition, regardless of my class attendance record or withdrawal. Signature______________________________________________________________________


See financial assistance section of p. 19 for more info on scholarships and payment plans  22


Want to guarantee your spot?


Become a member today!


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