Fine~Art~Colleges~Foundation~Programs~Lyme Academy College of Fine Arts

Continuing Studies and Pre-College -

On-Line Registration Form

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For information:

Kathy Young-Murphy
Interim Director
Part-time and Continuing Studies
860-434-5232
kyoungmurphy @lymeacademy.edu

THIS FORM IS FOR NON-CREDIT CONTINUING STUDIES AND PRE-COLLEGE COURSES ONLY. TO REGISTER FOR BFA LEVEL CLASSES,
CONTACT KATHY YOUNG-MURPHY AT: 860-434-5232 ext 120

For instructions on how to register for non-credit classes, click here.

Personal Information
First Name:		Last Name:
E-mail:
Street Address
City		State	Zip
Home Phone		Cell Phone
Gender	Male Female	Date of Birth
College(s) attended
Emergency Contact		Phone

Are you taking these classes for credit if available?		Yes No
If you take classes for credit, we will be contacting you for your Social Security Number.

Pre-College student information only: (Pre-College students are 12-18 years old)

Parent/Legal Guardian	Parent Phone:
High School	Year in School
If applying for a scholarship based on financial need, please print out the scholarship application and mail it in after completing this online form. Click here for Scholarship and Transportation Form.		Are you applying for a scholarship? Yes No

Course Selection:
Prices listed with course include model and/or material fees. A $50 registration fee is due once each summer and semester.

Summer 2008:

1

2

3

4

How would you like to pay for your classes?

	Online - An invoice will be e-mailed to you with a link to pay through PayPal. You do not need a PayPal account.
	Mail or hand deliver payment. You will receive an e-mail with a printable invoice. (Pre-College students applying for a scholarship should choose this option)
You will not be officially registered for classes until payment is received.

- Please only click once. The form will take a few minutes to process.

Early registration is advised to prevent the disappointment of a filled class. Payment is due in full at time of registration. Once registered there are no refunds unless Lyme Academy cancels a class. Please contact Kathy Young-Murphy at 860-434-5232 ext 120 or kyoungmurphy@lymeacademy.edu with any questions regarding registration.

This form is for Continuing Studies and Pre-college students only.

REQUEST COLLEGE INFORMATION

~ Lyme Academy College of Fine Arts ~
84 Lyme Street Old Lyme, Connecticut 06371 - T: 860.434.5232 F: 860.434.8725