Register - Thillai

Thillai Fine Art's Registration Form

Thank you for your interest in Thillais Offerings. Please fill the below form for registering to our programs.

Student Information

Student First Name*

Student Last Name*

Age*

Email*

Street Address Line 1*

Street Address Line 2

City*

State*

Postal/Zip Code*

Country*

Phone*

Experience

Year of Experience*

Enrollment Year From

Enrollment Year To

Vision

Health Concerns (If any)

Parent Information

Parent First Name*

Parent Last Name*

Parent Cell Phone 1*

Parent Cell Phone 2

Parent Email 1*

Parent Email 2

Emergency Contact

Emergency Contact Name*

Contact Relationship*

Emergency Contact Phone*

Street Address

Street Address Line 2

City

State

Postal / Zip code

Country*

Class Information & Location

Location HillsboroughMorrisplains

Morrisplains: Confi Dance Center-32 Gibraltar Dr, Morris Plains, NJ 07950

Hillsborough: 41, Boehm Way, Hillsborough, NJ 08844

How did you hear about us?

Referral Name

Select an option
FlyerOther(specify)

TERMS AND CONDITIONS: 1. Payment Method: Electronic / Zelle
2. All Payments are due with the registration and on/before first class of every month.
3. Enrollment to classes is for standard academic year. Fees is non-refundable.
4. Class duration is 1 hour. No classes on major holidays.

Acknowledgement*:

I accept the above conditions to enroll in Classical Bharatanatyam Classes conducted by Thillai Fine Arts

Full name of Student/Parent *

Signed Date *