West Michigan Homeschool Fine Arts Online Registration

Registration

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INSTRUCTIONS: Please use capital letters properly! Do not use ALL capital letters or NO capital letters. - Thank you!

Please note that credit card information is optional. If you do choose to enter it, your card will not be billed. It will simply be stored on your account for your convenience when you are ready to pay.

* denotes required fields

Referral Information

How did you hear about us?*

Referral Name*

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Primary Phone*

Additional Info

Emergency Contact Info (Not Contact #1 or #2)

Parental Musical Experience?*

Partnership Name (or none)*

Contact #1

Contact #1 First Name*

Last Name *

Type*

How Can We Contact You?

Home Phone *

Work #

Cell # * Receive Text Message Notifications

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Contact #2

Contact #2 First Name

Last Name

Type

How can we contact you?

Home Phone

Work #

Cell # Receive Text Message Notifications

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications

Additional Info

Student Email

T-Shirt Size*

Disabilities

Special Needs

Allergies

Medications

Partnership Name (or none)

Graduation Year (if known)*

CLASS ENROLLMENT - Verify your class location! Kalamazoo and Grand Rapids have similar classes.

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications

Additional Info

Student Email

T-Shirt Size*

Disabilities

Special Needs

Allergies

Medications

Partnership Name (or none)

Graduation Year (if known)*

CLASS ENROLLMENT - Verify your class location! Kalamazoo and Grand Rapids have similar classes.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications

Additional Info

Student Email

T-Shirt Size*

Disabilities

Special Needs

Allergies

Medications

Partnership Name (or none)

Graduation Year (if known)*

CLASS ENROLLMENT - Verify your class location! Kalamazoo and Grand Rapids have similar classes.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications

Additional Info

Student Email

T-Shirt Size*

Disabilities

Special Needs

Allergies

Medications

Partnership Name (or none)

Graduation Year (if known)*

CLASS ENROLLMENT - Verify your class location! Kalamazoo and Grand Rapids have similar classes.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications

Additional Info

Student Email

T-Shirt Size*

Disabilities

Special Needs

Allergies

Medications

Partnership Name (or none)

Graduation Year (if known)*

CLASS ENROLLMENT - Verify your class location! Kalamazoo and Grand Rapids have similar classes.

Enroll in Classes

Select Class

Add Another Student

Required Policies

(Show-Hide Details)

Questions or Concerns

Comments

Payment Information

Credit Card

Card Number

Exp Month

Exp Year

Card Nickname

Name as it appears on card

Address Line 1

Address Line 2

City

State

Zip

Registration

Referral Information

Family Information

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Contact #2

How can we contact you?

Student #1

Additional Info

Enroll in Classes

Student #2 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #3 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #4 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #5 (Show-Hide Details)

Additional Info

Enroll in Classes

Required Policies (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Payment Information

Credit Card

Required Policies

(Show-Hide Details)