BMC Student Registration Form
Please note: a spot on the schedule will not be saved until the registration fee ($25) is submitted unless otherwise specified. The one-time fee can be paid online, in-store, or over the phone at (203) 792-4304.

For more information, please email info@bmcmusicsource.com or callĀ (203) 792-4304.
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Parent/Guardian's name *
Phone number *
Email address *
Address *
Zip code *
Student's name *
Student's age *
Instrument *
Any previous experience? If so, how many years? *
Do you have a preferred teacher?
Would you prefer in-person or remote lessons? *
Anything else you'd like us to know?
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