Competitive Arts and Academics Enrollment
Student Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date of Birth
Grade level
*
Gender
*
Male
Female
Is the student enrolled in Konos core courses?
*
Yes
No
If no, where does the student receive his or her primary instruction?
Student Email
example@example.com
Student Phone
-
Area Code
Phone Number
Parent Name
*
First Name
Last Name
Parent Email
*
example@example.com
Parent Phone
*
-
Area Code
Phone Number
Options
Chess (fall only) $175 membership fee + $50 competition fee
Chorus (fall and spring) $200 membership fee each semester + $25 competition fee (in fall)
Check here if taking Chorus AND Chimes (no add'l fee)
Hand Chimes Only (fall and spring) $50 membership fee each semester
Note: Students enrolled in chorus may play hand chimes for no additional fee.
Payment
*
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( X )
Chess membership fee (fall only)
$
175.00
Student
First student
1st sibling
2nd sibling
Chess competition fee
$
50.00
Chorus membership fee - each semester
$
200.00
Student
First student
1st sibling
2nd sibling
Chorus competition fee (pay in fall)
$
25.00
Hand Chimes Only (each semester)
$
50.00
Visual Arts Competition
$
25.00
Subtotal
$
0.00
Tax
$
0.00
Total
$
0.00
Submit
Should be Empty: