COMPUTER PROGRAMMING SUMMER 2013 PAYMENT/REGISTRATION FORM
Slater Music Academy is offering classes in Alice and Python programming. These classes will be held at
Notre Dame Academy in Park Hills, Kentucky. Each class is $150.
ALICE for Middle School Students (6/17/13 – 6/28/13 from 9:30 – 11:30 AM) We will explore the
fundamentals of computer programming with the ALICE programming language. ALICE provides a 3D
interactive programming environment. We will create new worlds with the ALICE properties, methods and
functions. We will use the variables, If/Else conditional statements and loops to create our computer
programs.
PYTHON for High School Students (6/17/13 – 6/28/13 from 12:30 – 2:30 PM) Learn to use the computer
programming language Python. It is free to download and is a great language to begin to learn how to
program using a high-level language. You will be introduced to the basics of programming and with these
concepts you will be writing your own programs.
All classes are taught by Jeffrey Slater
Jeffrey Slater is a licensed 5-12 math teacher in the Commonwealth of Kentucky. He has bachelor degrees
in secondary mathematics and information processing from Ball State University and the University of
Cincinnati. He also has a master’s degree in education from Northern Kentucky University. He has taught
high school math and computers for two years, middle school math and computers for six years, and was a
software developer for eighteen years. He lives in Ft. Thomas, Kentucky with his wife. Their oldest son is
studying electrical engineering at the University of Louisville and their youngest son is studying Classics at
Boston University.
SLATER MUSIC ACADEMY COMPUTER CLASS REGISTRATION FORM
Student name__________________________________Date of birth ________________
For what class are you registering? (circle) ALICE PYTHON
Parent/guardian name ______________________________________________________
Address_________________________________________________________________
City, state, zip code________________________________________________________
Day phone number_________________Evening phone number_____________________
Additional phone number(s)_________________________________________________
Emergency contact and phone number_________________________________________
Email address(es) (note – we will NEVER send you unsolicited email or give your email address to anyone
else. This is for communication purposes ONLY.)
Are there any medical conditions or handicaps that the instructor should know about? If so, please explain.
How did you hear about our computer classes?
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - I am paying by (check all that apply)
□ Check or money order (written to Slater Music Academy, $30 fee for returned checks)
□ Cash (exact change, please)
□ Gift certificate(s) and/or coupon (check expiration date and number of lessons required to receive
coupon discount; only one coupon per purchase)
□ Credit card (please complete credit card form below; receipts will be mailed)
Credit card payment form
□ Mastercard
□ Visa
□ Discover
Card # _______________________________________Expiration date______/______Amt.____________
Month Year
CVV2# (3-digit number on the back of your credit card)_________________________________________
Brief description of services purchased_______________________________________________________
Name as it appears exactly on card:_________________________________________________________
Address: Street__________________________________City______________State_______Zip________
Signature______________________________________________________________________________
I agree to pay above total amount according to card issuer agreement.
----------------------------------------------------------------------------------------------------------------------------- ---Slater Music Academy
P.O. Box 75049
Fort Thomas, KY 41075-0049
phone: 859-486-1032, fax: 859-908-2607
www.slatermusicacademy.com
[email protected]