Arts Middle School

Arts Middle School
Grades 6-8

MIDDLESEX COUNTY ARTS MIDDLE SCHOOL
APPLICATION 2011-2012 SEASON

Student's First Name:		Student's Last Name:

Address 1:		Address 2 (Apt #):
City:		Zip:
Home Phone:		Cell Phone:
Email:		Date of Birth:
Mother's Email:		Father's Email:
School Attending: Select Grade: Are you a returning student? If yes, please list the name of the most recent class and year you attended. Course: Year:
I would like to audition for the class. (OPTIONAL) I would also like to audition for the class.

If you are auditioning for Jazz Improv, please specify which instrument you play:

		Please select payment method:
*Audition Fees:		$35 for ONE Artform or $50 for TWO Artforms
Name on card:		Card number:
		Expiration date: /