TRHS Lesson Funds Request

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Complete this entire form to request a funds transfer from a TMA student account to his/her TRHS Music Lessons account. Please allow two weeks for transfer to be processed.

Email *

Student Name *

Student Grade *

Phone number *

Requested Transfer Amount *

Terms and Conditions and Acknowledgements *

Please check each of the boxes to acknowledge and agree to the terms and conditions of this transfer. I understand that transferring funds from my account:

is permanent and non-refundable.

will result in the money no longer being in my TMA student account to pay for future music department trips.

will be paid directly to the TRHS music office and not to me personally.

will be used for TRHS music lessons only, which I am responsible to schedule with the TRHS music office.

may only be used for my TRHS music lessons or those of my immediate family member(s) residing in the same household (i.e., sibling) and may not be "gifted" to anyone else.

Required

Authorization *

By typing my name below, I hereby authorize TMA to transfer the requested funds from my TMA student account to my TRHS music lesson account. I understand that once this transfer is made, it is irreversible, and that the funds will no longer be available for me to use for future music department trips or for any other purpose. This form must be signed by a parent/guardian if the student is under age 18.

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