<p> P.O. Box 1325, 245 E. High Street Pottstown, PA 19464 610.970.1199; www.steelriver.org</p><p>PAYMENT FORM for PRIVATE LESSONS 2017/18 School Year FORM D - Must be attached to appropriate registration form(s)</p><p>Student Name: ______</p><p>TUITION CALCULATION AND PAYMENT WORKSHEET</p><p>Annual Registration Fee: $______($20/year per student for private lesson students covers private lesson & camp instruction from July 1-June 30)</p><p>(If you paid this for a 2017/18 camp registration earlier in the year, you do not need to pay it again for private lessons) ------PRIVATE LESSONS</p><p>See the private lesson pricing information in the Info Sheet for your exact fee. Drop in rates for 2017/18 school year are:</p><p>How long do you want your lesson to be? 30 minutes 45 minutes 60 minutes (circle one)</p><p>Which Instructor are you meeting with? ______</p><p>Have you scheduled your lesson time? If so, please write your time and day of the week here: ______</p><p>Calculate your rate:</p><p>I am signing up for a semester session (11 lessons and the recital or 12 lessons) and my rate (based on the 2018 information sheet) is: ______</p><p>I would prefer to take ______single lessons at $______per lesson.</p><p>I AM A VOCALIST WHO WOULD LIKE TO PERFORM IN THE RECITAL:</p><p>Vocal Recital Fee: $______$10/semester to pay recital pianist. </p><p>I am a vocal student but will not be performing in recitals</p><p>Total Private Lesson(s) Payment Due: $______------GROUP CLASSES/WORKSHOPS Use the Group Class form to calculate your payment for Group Classes – no registration fee is required for taking group classes. </p><p>Total Group Classes/Workshop Payment Due: $______</p><p>------Annual Fund Donation: $______(Optional. Thank you for supporting the Steel River Playhouse)</p><p>Deductions: - $______(Have a gift certificate, include this amount here and attach your certificate to the back of your form</p><p>TOTAL AMOUNT DUE $______(Add together all amounts above)</p><p>PAYMENT METHOD:</p><p>CHECK PAYMENT (Please make check payable to “Steel River Playhouse”)</p><p>Check Number: ______Amount: $______</p><p> CREDIT CARD PAYMENT: (If paying by credit card, please complete information on attached sheet OR visit our webpage at www.steelriver.org and use the donation button to pay online. Email [email protected] to notify her that your payment has been made)</p><p>OR USE THIS FORM</p><p>Student Name:______</p><p>Payment Description:______</p><p>Paying in One Installment Amount: $ ______OR Add $10 if paying 3 monthly installments $______</p><p>CREDIT CARD TYPE: ___VISA ___MASTERCARD ___DISCOVER ___AMEX </p><p>Name on Card (if different than above): ______</p><p>Card #: ______</p><p>V-Code______Exp. Date: ______/______</p><p>Billing Address (including zip):______(REQUIRED when “keying” the card in instead of swiping) </p><p>Phone Number to call if any questions about this charge: ______</p><p>Email if you would like a receipt:______</p><p>When paying with credit card, you may pay full amount due in three monthly installments. There is a $10 Convenience fee for this service. </p>