Waldorf Music Academy Enrollment Form
Email *
Student Last Name *
Student First Name *
Parent Name (if applicable)
Student or Parent Email
Student or Parent Cell Phone Number *
Mailing Address *
Emergency Contact Name  *
Emergency Contact Relationship *
Emergency Contact Cell Phone  *
Emergency Contact Email  *
Student's Birth Date *
MM
/
DD
/
YYYY
How did you find out about WMA? *
You (or your child) would like to take lessons for: *
Lesson Location *
Student's Current Skill Level
Preferred Time of Day *
Preferred Days (Select all days available) *
Required
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