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Waldorf Music Academy Enrollment Form
* Indicates required question
Email
*
Record my email address with my response
Student Last Name
*
Your answer
Student First Name
*
Your answer
Parent Name (if applicable)
Your answer
Student or Parent Email
Your answer
Student or Parent Cell Phone Number
*
Your answer
Mailing Address
*
Your answer
Emergency Contact Name
*
Your answer
Emergency Contact Relationship
*
Your answer
Emergency Contact Cell Phone
*
Your answer
Emergency Contact Email
*
Your answer
Student's Birth Date
*
MM
/
DD
/
YYYY
How did you find out about WMA?
*
Your answer
You (or your child) would like to take lessons for:
*
Piano
Drums
Vocal
Guitar
Bass Guitar
Violin
Lesson Location
*
In-Person (Waldorf, MD Location)
Virtual
Student's Current Skill Level
Your answer
Preferred Time of Day
*
Morning
Early Afternoon
After School (4 pm - 6 pm)
Evening School (6 pm - 8 pm)
Preferred Days (Select all days available)
*
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Required
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