2008 Tomato Patch Registration Form


Please print this form, and mail the completed form with payment to:

Tomato Patch 2008
Mercer County Community College
P.O. Box B
Trenton, NJ 08690

You will receive more information and a course selection form by return mail.
All courses are filled on a first come / first served basis.

Student's
Last name
Student's
First name
Parent/Guardian's
Last name
Parent/Guardian's
First name
Street Home phone
City Best time to call home phone
State & Zip Work phone
e-mail address t-shirt size (adult sizes)

____ Male ____ Female Age Grade in fall 2008

Have you attended Tomato Patch in the past? ___ No ___ Yes, in _______

Circle the Desired Dates and Tomato Patch Choice

Dates For Grades Tomato Patch Choice Tuition
June 23-July 17 (Session 1) 8-12 Visual Arts emphasis $625
June 23-July 17 (Session 1) 8-12 Performing Arts emphasis $625
July 21-August 7 (Session II) 5-7 Visual Arts emphasis $525
July 21-August 7 (Session II) 5-7 Performing Arts emphasis $525
July 21-August 8 (Session II) 8-12** Performing Arts Master Class** $475
Total Tuition for All Circled Tomato Patch Choices $
Non-refundable application fee that must accompany this form + $25
Total Registration Cost  

**Participants must have attended or be signed up for Session 1, TP On & Off Screen or had other formal theater training.

I give Mercer County Community College consent to use the name and/or photograph of the above registered camper for inclusion in promotional materials related to "Tomato Patch". These include and are not limited to newspaper, television and brochures. I waive the right to approve such issues and I release Mercer County Community College from any and all liability should any occur.

Signature of Parent/Guardian____________________________________________

Payment

You may pay by check or by Visa or MasterCard. NOTE: You must pay the $25 non-refundable application fee with this application. You may also pay the total tuition now or when you submit the completed course selection form. Tuition now includes t-shirt, Pizza Party on performance dates, 2 tickets for each performance and DVD of art exhibit and festival.

___ I will pay only the $25 registration fee now and pay the tuition of $ _______ with the course selection form. OR
___ I will pay the total registration cost now.

Method of Payment

___ Check payable to Tomato Patch/MCCC. Include the student's name on the check or money order. OR
Charge to:
___Visa
___Mastercard

___Amex

Card
Number
3 Digit Code
on back of card
Expiration
Date
Cardholder's
Name
Cardholder's
Signature

Tomato Patch is funded in part by The Mercer County Cultural and Heritage Commission

and the NJ State Council on the Arts/Department of State

    



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