SlideShare a Scribd company logo
1 of 1
Download to read offline
The Early Childhood
                                                                                            Division of




                                                             P.O. Box 81003  Lansing, MI 48908
                                                            www.codamts.com  (517) 862-4675
                                                       Providing Creative Opportunities for Developing Abilities


                           Early Childhood Music & Movement Classes
                             Registration Form: Spring 2011 Session
Spring 2011 Session will be a 10-week session from Mar. 7 - May 20. No class during spring break; make-
ups week of May 22, if needed. Please indicate preferred enrollment option.


Child’s Name: ____________________________________                          Birthdate: ______________

        INFANT/TODDLER CLASSES (Birth-3)                            PRESCHOOL CLASSES (3-5)

     ___ Tuesday, 5:30-6:15pm ($150)                     ___ Tuesday, 6:30-7:15pm ($150)

     ___ Saturday, 10-10:45am ($150)                     ___ Saturday, 11-11:45am ($150)


  ___ Yes, I qualify for the Military Rate ($120)
  ___ Yes, I have already registered another child for SPG Classes. Sibling Rate: $120
         Name of sibling: ________________________________
  ___ Yes, I have a discount coupon! (May not be combined with military or sibling rate.)
         Coupon code: __________             Discount Amount: ________
  ___ Yes, I am registering by February 25, 2011. Early Bird Discount: $10 off
         (Early Bird Discount may be combined with other discount.)

                                                                           Registration Cost: ________
                                                                           Discount Amount: ________
                                                                           Registration Total: ________

       Indicate Payment Method: Cash___ Check___ Money Order___
         Make checks payable to: CODA Music Therapy Services, LLC
      ___ Paid in full
      ___ Pay in two installments, balance will be due APRIL 16

More Related Content

Viewers also liked

PrePAN - DISられないCPANizeを目指して
PrePAN - DISられないCPANizeを目指してPrePAN - DISられないCPANizeを目指して
PrePAN - DISられないCPANizeを目指してKentaro Kuribayashi
 
5 Encontro das escolas do campo
5 Encontro das escolas do campo5 Encontro das escolas do campo
5 Encontro das escolas do campostlnossosenhor
 
Egyenlő eséllyel
Egyenlő eséllyelEgyenlő eséllyel
Egyenlő eséllyelszaboblzs
 
Ppt.5e.descriptions
Ppt.5e.descriptionsPpt.5e.descriptions
Ppt.5e.descriptionsticheroki
 
Branches of government games
Branches of government gamesBranches of government games
Branches of government gameskefinner
 
SSH Suncusuna Nasıl Güveniyoruz?
SSH Suncusuna Nasıl Güveniyoruz?SSH Suncusuna Nasıl Güveniyoruz?
SSH Suncusuna Nasıl Güveniyoruz?Necdet Yücel
 
ウィキペディアって何?橋本版
ウィキペディアって何?橋本版ウィキペディアって何?橋本版
ウィキペディアって何?橋本版Masa Miya
 
Presentación proyecto canaima
Presentación proyecto canaimaPresentación proyecto canaima
Presentación proyecto canaimaEnrique Garcia
 
はてながフェイスブックに 勝つるたったひとつの理由
はてながフェイスブックに 勝つるたったひとつの理由はてながフェイスブックに 勝つるたったひとつの理由
はてながフェイスブックに 勝つるたったひとつの理由MOHRI Taroh
 
とべとべ vol.9【第二部】「現役エンジニアが語る成長とデスマーチの関係」
とべとべ vol.9【第二部】「現役エンジニアが語る成長とデスマーチの関係」とべとべ vol.9【第二部】「現役エンジニアが語る成長とデスマーチの関係」
とべとべ vol.9【第二部】「現役エンジニアが語る成長とデスマーチの関係」Hiromu Shioya
 

Viewers also liked (13)

PrePAN - DISられないCPANizeを目指して
PrePAN - DISられないCPANizeを目指してPrePAN - DISられないCPANizeを目指して
PrePAN - DISられないCPANizeを目指して
 
rdla Work
rdla Workrdla Work
rdla Work
 
5 Encontro das escolas do campo
5 Encontro das escolas do campo5 Encontro das escolas do campo
5 Encontro das escolas do campo
 
Sinthanai thiran
Sinthanai thiranSinthanai thiran
Sinthanai thiran
 
ใบงาน แบบสำรวจและประวัติ(พี)
ใบงาน แบบสำรวจและประวัติ(พี)ใบงาน แบบสำรวจและประวัติ(พี)
ใบงาน แบบสำรวจและประวัติ(พี)
 
Egyenlő eséllyel
Egyenlő eséllyelEgyenlő eséllyel
Egyenlő eséllyel
 
Ppt.5e.descriptions
Ppt.5e.descriptionsPpt.5e.descriptions
Ppt.5e.descriptions
 
Branches of government games
Branches of government gamesBranches of government games
Branches of government games
 
SSH Suncusuna Nasıl Güveniyoruz?
SSH Suncusuna Nasıl Güveniyoruz?SSH Suncusuna Nasıl Güveniyoruz?
SSH Suncusuna Nasıl Güveniyoruz?
 
ウィキペディアって何?橋本版
ウィキペディアって何?橋本版ウィキペディアって何?橋本版
ウィキペディアって何?橋本版
 
Presentación proyecto canaima
Presentación proyecto canaimaPresentación proyecto canaima
Presentación proyecto canaima
 
はてながフェイスブックに 勝つるたったひとつの理由
はてながフェイスブックに 勝つるたったひとつの理由はてながフェイスブックに 勝つるたったひとつの理由
はてながフェイスブックに 勝つるたったひとつの理由
 
とべとべ vol.9【第二部】「現役エンジニアが語る成長とデスマーチの関係」
とべとべ vol.9【第二部】「現役エンジニアが語る成長とデスマーチの関係」とべとべ vol.9【第二部】「現役エンジニアが語る成長とデスマーチの関係」
とべとべ vol.9【第二部】「現役エンジニアが語る成長とデスマーチの関係」
 

Similar to Sing Play Grow, Spring 2011 Registration Form

Similar to Sing Play Grow, Spring 2011 Registration Form (7)

SPG Registration Packet - Fall 2011
SPG Registration Packet - Fall 2011SPG Registration Packet - Fall 2011
SPG Registration Packet - Fall 2011
 
\'Sing Play Grow\' Registration Packet - Winter, Spring 2012
\'Sing Play Grow\' Registration  Packet - Winter,  Spring 2012\'Sing Play Grow\' Registration  Packet - Winter,  Spring 2012
\'Sing Play Grow\' Registration Packet - Winter, Spring 2012
 
Little Explorers Registration Form
Little Explorers Registration FormLittle Explorers Registration Form
Little Explorers Registration Form
 
Sing Play Grow Enrollment Form
Sing Play Grow Enrollment FormSing Play Grow Enrollment Form
Sing Play Grow Enrollment Form
 
Registration form insert
Registration form insertRegistration form insert
Registration form insert
 
ON TASC De-escalation flyer 4-5-2011
ON TASC De-escalation flyer 4-5-2011ON TASC De-escalation flyer 4-5-2011
ON TASC De-escalation flyer 4-5-2011
 
Overnight Camper App 2011
Overnight  Camper  App 2011Overnight  Camper  App 2011
Overnight Camper App 2011
 

Sing Play Grow, Spring 2011 Registration Form

  • 1. The Early Childhood Division of P.O. Box 81003  Lansing, MI 48908 www.codamts.com  (517) 862-4675 Providing Creative Opportunities for Developing Abilities Early Childhood Music & Movement Classes Registration Form: Spring 2011 Session Spring 2011 Session will be a 10-week session from Mar. 7 - May 20. No class during spring break; make- ups week of May 22, if needed. Please indicate preferred enrollment option. Child’s Name: ____________________________________ Birthdate: ______________ INFANT/TODDLER CLASSES (Birth-3) PRESCHOOL CLASSES (3-5) ___ Tuesday, 5:30-6:15pm ($150) ___ Tuesday, 6:30-7:15pm ($150) ___ Saturday, 10-10:45am ($150) ___ Saturday, 11-11:45am ($150) ___ Yes, I qualify for the Military Rate ($120) ___ Yes, I have already registered another child for SPG Classes. Sibling Rate: $120 Name of sibling: ________________________________ ___ Yes, I have a discount coupon! (May not be combined with military or sibling rate.) Coupon code: __________ Discount Amount: ________ ___ Yes, I am registering by February 25, 2011. Early Bird Discount: $10 off (Early Bird Discount may be combined with other discount.) Registration Cost: ________ Discount Amount: ________ Registration Total: ________ Indicate Payment Method: Cash___ Check___ Money Order___ Make checks payable to: CODA Music Therapy Services, LLC ___ Paid in full ___ Pay in two installments, balance will be due APRIL 16