Order Form Ages 11-12

Abbey School of Music & Drama – Child Ages 11-12/ Order Form

PLEASE SEE WEB PAGE FOR FULL DETAILS AND TIMES FOR THIS COURSE AT www.dublin.ie/websites/abbeyschool/drama-(ages-11-12).asp

TO RESERVE: Email Kathleen Warner Yeates at kwyeates@gmail.com OR ring 086 824 4826. Once availability has been confirmed, print the order form below and send along with payment as instructed below. Non-refundable deposit must be received within 3 days of reservation. No places held more that 3 days without payment. The balance in full must be paid one week prior to the start of class by the date noted below. Reservation will be confirmed when payment/deposit is received. Refundable only in the event that the Abbey School of Music & Drama has to cancell.

(PRINT SELECTION BETWEEN DOTTED LINES BELOW FOR A4 SHEET)

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Flying Turtle Productions at The Abbey Schoool of Music & Drama

www.dublin.ie/websites/abbeyschool/youth-drama.asp

RESERVATION/PAYMENT FORM

Children's Drama Ages 11-12 - Winter 2012

Kindly fill in Payment Amount Enclosed:

€________Course G- Studio ProcessTerm: Saturdays 1:30-2:30pm, January 21st-March 10th, 2012.

FEE: €95, minumum deposit of €40 due within 3 days of reservation. Remaining balance due by January 14th, one week prior to start. Note here if this is a sibling of another student, and deduct €20 from payment due. Name of other sibling enrolled (separate form required)_________________________

Payments accepted by Paypal email invoice, cash, personal check, bank draft, or postal money order. Cheques MUST be payable to KATHLEEN YEATES (not Abbey School)

Bank Transfer also accepted to Bank of Ireland, Sort Code: 90 05 43 Acct #82948654 (Include Student Name)

Please post form and payment details to: Attn:Kathleen Yeates c/o Abbey School of Music & Drama, 9b Abbey St. Lower, Dublin 1

Classes held at the Abbey School of Music & Drama, 9b Abbey Street Lower, Dublin 1

Presentations held at Pearse Centre, Ireland Institute, 27 Pearse Street, Dublin 2

Kindly fill in the information and contact details below, PRINT, and return with payment:

Student Name:______________________________________Student's Age________

Parents/Guardian Names:___________________________________________________

Full postal mailing address:_________________________________________

____________________________________________________________

Email addresses:_______________________________________________

Contact Phone Numbers (PLEASE FILL IN ALL AVAILABLE)

Parent / Guardians Home:________________________________________

Parents Mobiles:________________________________________________

Student Mobile:________________________________________________

Please fill in any pertinent information regarding medical conditions, home situations, or other relevant details.

_____________________________________________________________

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Please note below any additional adults who are permitted to pick-up your child after class or if your child has permission to leave the building unaccompanied.

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Parent Signature______________________________________Date________

                                                                      (Circle one)

Total payment amount of_____________  cash /cheque/Bank Transfer Date________   THANK YOU!

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The Abbey School of Music & Drama

Order Form Ages 11-12