Summer Program 2015

Lessons
Offered

Piano
Voice
Please Note:
Not all areas
Woodwinds
have the
Brass
option of a
Master or
Strings
Junior
Guitar
Instructor
Percussion
Music Fundamentals
Composition
Acting
Dance

Lessons: 5 or 10 Weekly lessons of 30, 45, or 60 Minutes

Location: UAFS Campus, Echols Building
Time: Arranged for convenience of student and instructor
Ages: 5 Adult
Please see dates & provide lesson
information on the reverse side
The best way to accelerate your learning in the arts is with
private one-on-one instruction. With our qualified and
acclaimed instructors, you will gain skills to last a lifetime.

NHAN NGOC NGUYEN

Students Full Name: _____________________________________________ M/F: __________________________

M

721 MACDILL ROAD

Address: ________________________________________________________________________________________
MIDDLE RIVER/MD/21220
City/State/Zip: __________________________________________________________________________________
Home Phone: ___(

___

)______________________ Cell Phone: ___(

___

)____________________

E-Mail: _____________________________________________________________________
NHANNGUYENNGOCVN@GMAIL.COM
Date of Birth: _______________________________________
Age: __________________
11/26/1996
18
School: _______________________________________
Grade (Fall 2015): ________
UAFS
Parent/Guardian Name Printed: ____________________________________________

Ethnic Background:

White/Caucasian

Asian

African American

For Office Use Only:

@_______________________
CRN __________ __________
S
R
C

Hispanic

Other

Parent/Guardian Signature: _________________________________________________

PAYMENT INSTRUCTIONS:
A $100 deposit is due with the registration. This deposit is non-refundable. This will be applied to the tuition. Please
make checks payable to UAFS Academy of the Arts. You may also pay by credit card. UAFS does not accept American
Express. Send payment and registration to the address below.
For more information contact:
Dr. Rosilee Walker Russell
Executive Director at 479-788-7546 or
Brooke Bates at 479-788-7253 or
E-mail at brooke.bates@uafs.edu

UAFS
Attn: Debbie Mays
PO Box 3649
Fort Smith, AR 72913-3649
Web address: www.uafs.edu/academy

UAFS reserves the right to use photos of all Academy students in promoting the arts.

For Office Use Only:

Tuition
________
__________Amt Pd ________
__________Amt Pd ________

Please mark the appropriate class NOTE DATES

Master Instructor
Dates

No. of Weeks

30 Minutes

45 Minutes

60 Minutes

May 26 - June 29

$165

$240

$300

June 30 August 3

$165

$240

$300

May 26 August 3

10

$325

$480

$600

Junior Instructor
Dates

No. of Weeks

30 Minutes

45 Minutes

60 Minutes

May 26 - June 29

$125

$175

$225

June 30 August 3

$125

$175

$225

May 26 August 3

10

$250

$350

$450

**Junior Instructors ONLY available for Piano, Voice, Violin, Guitar, and Dance**

NHAN NGOC NGUYEN

Student Name: _____________________________________________________________________________
Specify the name of the Instructor (if known) ______________________________________________
Specify type of instrument/voice: __________________________________________________________
PIANO (CLASSICAL)

Tuition Due Dates: Tuition for 5-week private instruction must be paid in full prior to the first lesson,
either May 26 or June 30. 10-week lessons may be made in two payments, on May 26 and June 30.
Reminder, the $100 registration deposit is applied to the tuition.

For Office use ONLY:

Instructor Contact Date: _______________________
Instructor Confirm Date: ________________________