Digital Illustration in Motion, COMD 101S-01⦠... PARENT / GUARDIAN SIGNATURE ... VISA. MasterCard. Amex. Discover. Ch
SPRING 2017 PreCollege Registration Form To register email form and payment information to
[email protected] with subject line SPRING 2017 REGISTRATION & LAST NAME OF STUDENT
STUDENT INFORMATION First Name ___________________________________________________ Last Name ___________________________________________________ Address ___________________________________________________ _____________________________________________________________ City
State
Zip Code
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Home Phone # _____________________ Cell # _____________________ Email Address ________________________________________________ High School ____________________________ Graduation _____ / _____ month
year
Date of Birth _____ /_____ /_____ Gender __________________________ month
day
year
How did you hear about us? ______________________________________ PARENT / GUARDIAN INFORMATION Parent / Guardian Name _________________________________________ Phone / Cell # __________________ Work Phone # __________________
TWO CREDIT COURSES
TUITION
Architecture, ARCH 100S-01………...……………………………….…... ...$1845 Sat 9:00am-1:20pm, 10 sessions Art and Design Discovery, FDN 103S-01……….......………….......…... ...$1845 Sat 2:00-6:20pm, 10 sessions Creating Worlds: Intro to Fiction, WR 104SP-01…………….....................$1845 Sat 2:00-6:20pm, 10 sessions Digital Illustration in Motion, COMD 101S-01……….……..……...…..... ...$1845 Sat 2:00-6:20pm, 10 sessions Digital Imaging & Photography, PHOT 106S-01…………...……...............$1845 Sat 2:00-6:20pm, 10 sessions Fine Arts: Painting & Drawing, FAU 100S-01……………...………............$1845 Sat 2:00-6:20pm, 10 sessions Graphic Design, COMD 105S-01…………..………………………….........$1845 Sat 9:00am-1:20pm, 10 sessions
Email Address ________________________________________________ PROGRAM CONSENT By signing below, I agree to the following statements: • MEDICAL RELEASE: I represent that I am the parent or legal guardian of the child that I am enrolling and I hereby give authority to Pratt Institute to obtain medical treatment in the case of emergency. • PHOTO / MEDIA RELEASE: I hereby give permission for my child and his/her artwork to be photographed and or videotaped and any photo/video taken to be used for promotional media. • FIELD TRIP PRELEASE: I grant permission for my child to go on field trips and release Pratt from liability during studio work, trips, and other events. PARENT / GUARDIAN SIGNATURE _______________________________________________
Industrial Design, IND 101S-01………………………...………....…...........$1845 Sat 9:00am-1:20pm, 10 sessions Interior Design, INT 101S-01…………………………………….…..............$1845 Sat 9:00am-1:20pm, 10 sessions NON CREDIT COURSES
TUITION
Architecture Design Studio, PMPC 107-01 Sat 2:00pm-5:00pm, 10 sessions………………………………....….............$470
PAYMENT TOTAL (Including $25 registration fee per semester) ______________________ VISA
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CARD NUMBER _____________________________________________________________ EXP DATE CVS # / SECURITY CODE ____________________________________________ NAME AS IT APPEARS ON CARD _______________________________________________ SIGNATURE __________________________________________________________________
Fine Arts Studio Practice, PMPC 116-01 Sat 10:00am-1:00pm, 10 sessions……………………..………...…..............$470 Portfolio Development, PMPC 114 Sec 01 Sat 10:00am-1:00pm, 10 sessions……………...…………..............$470 Sec 02 Sat 2:00pm-5:00pm, 10 sessions………........…………….....……...$470
