Bergen Academy of Music and Art REGISTRATION
SUMMER SESSION 2021
June 28 - August 7/14/21 (6 week, 7 week or 8 week option)

After submitting your registration, we will contact you regarding scheduling and tuition payments.

*Please complete a separate form for each student and/or instrument.

Bergen Academy of Music and Art
244 Kinderkamack Rd.
Oradell, NJ 07649
201-940-2200
hello@bergenacademy.com
www.bergenacademy.com

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Email *
Student Name (First, Last) *
Student Birthdate (Month/Day/Year) *
Please choose one: *
If Current or Former Student, your teacher's name:
Instrument Choice *
Current Level of Experience: Beginner/Intermediate/Advanced? If applicable, please include years of study or any additional helpful info regarding level of study. *
Lesson Preference: *
Desired Lesson Length *
Summer Lesson Package Choice: (If starting after  the week of June 28th, please choose "OTHER" and fill out the following question regarding number of lesson weeks.) *
If beginning lessons after the week of June 28th, please let us know which week you'd like to begin, and whether you would like to have your final lesson the week of Aug 9th or the week of Aug 16th.
Will you be registering an additional instrument and/or household family member? (Tuition discounts available for additional enrollments) *
If registering an additional instrument and/or family member, please include the instrument or family member name (and submit a separate registration form for each). If none, please skip.
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