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Grade 6 Moose Jaw Band Registration

Please complete the form below. Required fields marked with an asterisk *

Today's Date*

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Student Information

Last Name*

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First Name*

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Parent Information

Last Name*

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First Name*

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Parent/Guardian e-mail*

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Parent/Guardian Phone Number*

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Relationship to student*

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Mother

Father

Guardian

Other:

School Student Attends*

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Instrument Choice #1*

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I allow my child’s picture to be shown on the band website.*

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Yes

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Payments

How would you like to pay?*

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Cheque - full amount $110

Credit Card - full amount $110

Cash $110

Postdated cheques - $55 September 1, $55 October 1(Make cheques payable to HTCSD)

Cheques may be mailed to: 445 13th Avenue NE, Moose Jaw, S6H 6B9

Grade 6 Band Fees - check this box to pay via credit card.

Price: $110.00

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Holy Trinity Catholic School Division

445 - 13th Avenue NE
Moose Jaw, SK S6H 6B9 Phone: 306-694-5333
Fax: 306-692-2238

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