Registration Form

Registration Form

You may register online by filling out all the fields below and pressing the submit button at the bottom of this form. Alternatively, you may print this page in form of a Microsoft Word Document or an Adobe PDF on your computer and mail the registration form to our address.

Please submit your registration fee by mail regardless of how you register (online or mail). This can be paid by check or cash. The Music Fee and Lesson Fees will be billed in August.

REGISTRATION FEE
Individual: $20
Family or multiple instruments: $30

MUSIC FEE:
Piano students: $25 per YEAR
All other students: $10 per YEAR

All student registrations are bound to our school policies.

Requests for day/ time teacher will be honored in the order received.

Deadline for current students: June 30.
New students will be scheduled after July 1.

STUDENT 1:

NAME:
School:Grade (2010-2011)
Birthday:(Children only)
Lesson Day/Time/ Teacher Request:

STUDENT 2:

NAME:
School:Grade (2010-2011)
Birthday:(Children only)
Lesson Day/Time/ Teacher Request:

ADDRESS:
CITY:
ZIP:
PHONE NUMBERS
Home:
Cell:
Work-(parent/self):
Other:
EMAIL:

Parent(s):
BILLING: IF DIFFERENT, list name & address of person responsible for payments:

LESSONS: You will be billed by August 1 with confirmation of lesson day & time.

Check your preferred method of payment below.
(Monthly payments available by Direct Deposit only.)

PRIVATE LESSONS:	MONTH (9)	SESSION (16 wks)	ALTERNATE WKS. (8 wks)
30-minute lessons	$70	$300	$150
45-minute lessons	$105	$450	$225
60-minute lessons	$140	$600	$300

“5-week (Sept. or Jan. only $105. total (Music Fee billed if lessons are continued).