If you have any questions or need any support, please call Harmony School 812.334.8349.
Contact information (1/2) Please list your name as you would like it to appear on your name tag and other materials.
Student first name
Student last name
Parent/Guardian Name
School
Birth Date
Home information	Street City State Zip Phone
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Course & Billing information (2/2)
Please select the courses you wish to attend: Design - Beginning Photoshop; June 8-19 Darkroom Photography - June 8-19 Computer Programming - Python; June 8-19 Film Shorts - iMovie & Final Cut Pro; June 8-19 ----- Design - Advanced Photoshop; June 22 - July 3 ----- Darkroom Photography - July 27 - August 7 Computer Programming - Python; July 27 - August 7 Digital Photography - July 27 - August 7 Electronic Music and Video Montage - Sony Suite; July 27 - August 7 Green Design & Technology - July 27 - August 7 ----- Multimedia - August 10-14 Fees (your registration will not be processed as complete until registration fees are received) Cost: $200 Registration fee (non refundable): $100 Per Class Balance Due May 15th to reserve space *10% discount for two courses, 20% for three
Payment Options Check/Invoice Make checks payable to Harmony School and mail to: Harmony School, Teen Media, PO Box 1787, Bloomington, IN 47402. Please enter billing information below. Credit card To pay with credit card, please follow the link to pay after you have submitted this form or call Harmony School at 812.334.8349 to pay by phone. If payment is not received within two weeks of registration form submission, we will invoice you at the address specified below. Please note, you must be paid in full by May 15 to be able to attend courses.
Billing address	Home address previously entered Other billing address (please enter billing address below)
Other billing address	Billing contact: Street City State Zip
Billing phone (include area code)
Are you completeing this registration for: Yourself A Student/Child/Someone Else If you are completing this registration for someone other than yourself, please let us know how to contact you with any questions: Your Name Your relationship to the participant you are registerting Your email address Your phone numer