Enrollment Form

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Enrollment Form

Please fill out completely

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Student Name *

Student Birthdate *

Student Current Grade *

Parent or Guardian Name *

Address *

Email (for Billing and Assignments) *

Parent Cell *

Additional Parent Cell

Lesson Length per week *

45 Min Lesson includes 15 minutes of Theory/Tech Lab

30 Minute Lesson - $100 per month

45 Minute Lesson - $140 per month

Please select all days that you are available for lessons *

Monday - 9:45am - 2:00pm

Tuesday - 4:00pm - 5:30pm

Wednesday - 9:00am - 5:00pm

Thursday - 4:00pm - 5:30pm

必須

Please select your preferred lesson time *

Homeschooled: Morning - 9:00am to 12:00pm

Homeschooled: Afternoon - 12:00pm to 3:00pm

After School: 4:00pm to 6:00pm

Do you have? *

We have a piano at home

We have a keyboard at home

We have an iPad our student can access at home

We have a laptop our student can access at home

We have a Kindle or similar tablet our student can access at home

We have a desktop computer our student can access at home

必須

Does your child have any previous music lesson experience? Please explain:

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