Thayer Symphony Orchestra

1. Thayer Symphony Orchestra Fall 2004 school semester fee for private lessons $338 (30 min.) $494 (45 min.) $780 (60 min.) Fall 2004 school semester fee for group lessons $130 (30 min.) $182 (45 min.) $234 (60 min.) A $15 ($25 max. per family) non-refundable registration fee (one time only) is due at time of registration Fall 2004 school semester = 13 weeks. All terms are pro-rated. Payment Plan: □ A □ B □ C(See details on Tuition Payment Plans form) Tuition $______________ Registration + $ _____________ Total = $ _____________ A = 1 Payment (9/6/04) B = 2 Payments (9/6 and 11/1/04) C = 4 Payments (9/6, 10/4, 11/1 and 12/6/04) PLAN “B” DueRec’vd 9/6/04 ______11/1/04 ______ PLAN “C” DueRec’vd 9/6/04 ______10/4/04 ______11/1/04 ______12/6/04 ______ PLAN “A” DueRec’vd 9/6/04 ______ SCHOLARSHIP DueRec’vd 9/6/04 ______10/4/04 ______11/1/04 ______12/6/04 ______ Fall 2004 Term – Registration Form Community Music School of Thayer Symphony Orchestra 14 Monument Square, Fourth Floor Leominster, MA 01453 Tel. 978 466-1800 Fax 978 840-1000 Student Name: ______________________________Date of Birth:__________ Male/Female:__________ Parent/Guardian: ____________________________Phone(H)_______________(W)_________________ Billing/Mailing Address: ________________________________________________________________ City/State/Zip: ________________________________________________________________________ Home E-Mail: ______________________________Work E-Mail:_______________________________ Teacher: ______________________________________________________ Instrument: ____________________________________________________ Lesson Day: __________________ Lesson Time: ______________ Lesson Length: ________________ Type:  Private  Group Beginning Date: ________________ # of Weeks:________________ Notes: ___________________________________________________________________________________ _________________________________________________________________________________________ □ AMEX □ DISC □ MC □ VISA Exp. Date________ □ Check Number: __________ □ Cash Card no. _______________________________________________ Name as appears on card: _________________________________ I have read the policies and agree to abide by them. _____________________________________ ____________________________________ ________ (Please Print Name) Signature of parent/guardian or adult Date OFFICE USE ONLY Please see reverse side for CMS’ Collection Policy

2. COMMUNITY MUSIC SCHOOL • COLLECTION POLICY • 1) No client leaves the office after initial registration without: • Completed registration form • Credit Card information (whether paying with credit card or not) • Deposit or balance paid • If desired, payment plan chosen • 2) Late payments of 30 days • • If paid by check or cash, a notice gets mailed. A verbal warning is given by the office staff, if convenient.3) Late payment of 45-60 days • • A second warning is given in the form of a telephone call. We reserve the right to charge your outstanding balance to your credit card on file at the office. • A late fee of $6 will be added to the monthly balance owed, and the student is removed from the teacher’s roster.4) Late payment over 60 days • • A second and final letter will be sent along with a phone call from the Executive Director, polite but stern in its intent. • • Every attempt will be made to arrange an alternative payment plan. • • Client is made aware that failure to pay will result in further legal action • I have read and agree to the Community Music School’s “Collection Policy” • __________________ ____________ • Initial Date