ROKSOLANA ART SCHOOL

 57 Newkirk Road, Unit 2, Richmond Hill

 Studio Tel: 416-893-0800  

School General Line:   (416) 893-0998

REGISTRATION FORM

Student's Name *
Returning Student NO YES
Date of Birth *
Home Address *
City
Province
Postal Code
Home Phone *
Cell Phone
Business Phone
Email *
Emergency Contact Name
Emergency Contact Number
*Health Issues: Does your child have any allergies, medication required, or any health or behavioral issues we should know about? NO YES

If Yes, please explain (Max. 500 character)

 
Day and Time of Attendance & Term *
Method of Payment Cheque Cash

All Fees are subjected to +13% HST. Please make cheque payable to IRRUCA INC.
Parent's Name
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 Designed by:Kian Parhizkari