Fillable TMISEP2019 Regform Revised (Howard Community College)

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TMISEP2019 Regform Revised (Howard Community College)

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The Music Institute
Summer Enrichment Program 2019 Registration Form
Please complete one form per student.
This registration form is to be used by all students registering for TMI Summer Enrichment Programs, except those
registering for the 2019 Extended Chamber Music Workshop, the Little Patuxent Opera Institute, or Private Lessons. For
the (Extended) GPT Adult Workshop and the LPOI program, those forms can be found online on the program’s respective
webpages. Private Lesson registrations are created by TMI Faculty Members and processed by the TMI Office.
A. Student Information:
_________________________________________________________________________________________ __________________
Last name First name Birth date (if under 18) HCC/TMI ID# Home Phone
____________________________________________________________________________________________________________
Street Address City and County State Zip Code
____________________________________________________________________________________________________________
School/Grade level Fall 2018 Current school music teacher/conductor Instrument(s) Years Playing
____________________________________________________________________________________________________________
Private Teacher Teacher’s Phone Number Piece playing presently/Composer
____________________________________________________________________________________________________________
Mother/Guardian Name Work Phone Cell Phone Email
____________________________________________________________________________________________________________
Father/Guardian Name Work Phone Cell Phone Email
B. Optional: Summer Enrichment Program Snacks and T-Shirts
As an added bonus, we are providing a snacks and a T-Shirt for each student, free of charge. Please let us know if you
would like your child to receive snacks and a T-Shirt. Please place an X by your response.
Snacks:
___ I would like my child to receive a snack (provided during the SEP break time).
___ I would NOT like my child to receive a snack (provided during the SEP break time).
T-Shirts:
___ I would like my child to receive a T-Shirt.
Sizes: Small ___ Medium ___ Large ___ X-Large ___
___ I would NOT like my child to receive a T-Shirt.
FOR OFFICE USE ONLY
TMI Summer 2019
Tuition
Total
Deposit
Payment
Date Paid
C. Music Programs:
Please check the music program or programs for which you are registering.
Music Institute Summer Enrichment Programs 2019
Program: Dates Running: Time: Payment Due
Drummin’ Dragons (Full Day) June 24 – June 28 8:30am – 4:30pm June 3
GPT Youth “Rising Stars” (Full Day) July 8 – July 12 8:30am – 4:30pm June 17
Summer Gumbo (Half Day/AM) July 15 – July 19 8:30am – 12:00pm June 24
Summer Gumbo (Half Day/PM) July 15 – July 19 1:00pm -- 4:30pm June 24
Summer Gumbo (Full Day) July 15 – July 19 8:30am – 4:30pm June 24
D. Tuition:
TMI offers two ways to reserve your spot. You may either submit a registration form along with a non-refundable deposit
of $50.00 by May 20, 2019 OR make payment in full by the dates listed above. If you opt for the non-refundable deposit,
the balance is due no later than three weeks prior to the individual program’s start date.
E. Payments:
Payments for summer programs are handled by the Cashiers Office, located on the 2
nd
Floor in the Rouse Center
Foundation (RCF) Building. You may place payments in the Drop Box in room 222 of the RCF Building (next to the
Cashiers Window). Payments may be made by Check (payable to HCC/TMI) or by cash or credit card to the Cashiers
Office. Payments may also be called in directly to the Cashiers Office at (443)-518-1862 or paid online via the CashNet
link included on your TMI e-invoice.
F. How To Register:
Registrations may be emailed to TMI@howardcc.edu or JBailey@howardd.edu or if you prefer
Registrations can be mailed to: The Music Institute, Howard Community College, HVPA 160A,
10901 Little Patuxent Parkway, Columbia, MD 21044 or if you prefer
Registrations may be faxed to (443) 518-4294 Attn: SUMMER MUSIC PROGRAMS; call (443) 518-4297 to
confirm receipt of fax.
The Music Institute SEP Consent Form 2019
The fillable Online Consent Form is available at:
www.howardcc.edu/discover/arts-culture/tmi/tmi-summer-enrichment-reg-from.html
THE SUMMER ENRICHMENT CONSENT FORM MUST BE SIGNED AND DATED TO BE OFFICIAL IN
ORDER FOR STUDENT TO BE REGISTERED.
Consent To Register:
I certify that I am registering my minor child for Summer Enrichment Programs at The Music Institute of Howard
Community College and that the above information is true and correct to the best of my knowledge. I understand that it is
my responsibility to notify the Records Office and The Music Institute of any change in the information contained in this
application. I will take financial responsibility for my child’s tuition payment due to Howard Community College
and The Music Institute
____________________________________________ ______________________________ _ _/ _ _/ _ _
Please Print/Type Name and Relation to Student Signature Date
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TMISEP2019 Regform Revised (Howard Community College)

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Completed 24 July 2020

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