Registration Forms for Classes for All Ages and Experience in Dance and Music

A Step Above Dance & Music Academy
5901 Monona Drive, Monona WI 53716
Phone: 608-221-4243
E-mail: asa8135@sbcglobal.net

Celebrating 20 Years!

Classes Registration Form

Please call our office at 608-221-4243
to discuss the classes that would be most appropriate to your goals, experience and their times.

You can fill out our online form or print our PDF form and bring it with you.

Monthy Postdated Checks

Please be assured that we do not share or sell personal information about you.

Family Last Name

Family Address

Billing Address (If different)

Family City

Family Zip

E-mail Address

Home Phone

Work Phone

How did you hear about our business?

Bold = Required field

Name of Parents student(s) lives with and their Work Schedules.

Name of person being billed

Emergency Phone

Cell Phone

Billing Zip

Billing City

1st Student's Name

1st Student's Birth Date

1st Student's Age

1st Student's Academic School

1st Student's Grade in 2008-09

1st Student's Gender

1st Student's Dance / Music Experience

2nd Student's Dance / Music Experience

2nd Student's Gender

2nd Student's Grade in 2008-09

2nd Student's Academic School

2nd Student's Age

2nd Student's Birth Date

2nd Student's Name

3rd Student's Name

3rd Student's Birth Date

3rd Student's Age

3rd Student's Academic School

3rd Student's Grade in 2008-09

3rd Student's Gender

3rd Student's Dance / Music Experience

If you have more than 3 Students, use this section to supply the same info required above for the other students.

Do any of these students have special needs of which we should be aware?

List the name of the student(s) and what classes you are interested in for all of your students. Our office will contact you to discuss times avaliable.

What type of billing are you interested in?

Quarterly Tuition payments

Yearly Payment in full

Monthly Credit Card payment

Monthly Debit Card Payment

Monthly Automatic Checking Withdraws

Click Here to open and print the
Registration Form

A $20.00 Non-Refundable Deposit must be received within 3 days to hold your students spot in class.