Please print, complete and return the registration form to:

Jean’s School of Dance, P.O. Box 235, Polson, Mt. 59860

*Please include tuition. E-mail or call with any further questions or concerns.

Thank you!

Student’s Name______________________________________

Age __________

Mailing Address______________________________________

Parent’s name_______________________________________

Phone ______________________

E-Mail Address ______________________________________

Classes you will be taking______________________________________________

Amount enclosed __________________