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Jubal Arts Center Registration for 2020/2021
Please complete the following information. You can pay your fees via E-Giving(easiest) or bring your registration form(see your email) and payment to East End Baptist Church(by appointment only at
jubalartscenter.eebc@gmail.com
)
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* Indicates required question
FIRST NAME OF STUDENT
*
Your answer
LAST NAME OF STUDENT
*
Your answer
STUDENT/PARENT PHONE NUMBER
*
Your answer
SEX
*
Female
Male
PARENTS' NAME(IF APPLICABLE)
Your answer
STUDENT'S ADDRESS(Please include city and zip code)
*
Your answer
EMAIL ADDRESS
*
Your answer
AGE OF STUDENT (IF UNDER 18)
Your answer
BIRTH DATE
*
MM
/
DD
/
YYYY
SCHOOL PRESENTLY ATTENDING(IF UNDER 18)
Your answer
NAME OF SCHOOL MUSIC TEACHER/DIRECTOR
Your answer
PHONE NUMBER/EMAIL OF TEACHER
Your answer
WHAT INSTRUMENT(S) ARE YOU REGISTERING FOR LESSONS IN?
*
PIANO
PERCUSSION
VOICE
STRINGS
WOODWIND/BRASS
SIGN LANGUAGE
PERCUSSION(DRUM SET)
Required
HAVE YOU STUDIED MUSIC BEFORE?
*
Yes
No
IF YES, HOW LONG?
*
0-2 YEARS
3-4 YEARS
5-6 YEARS
7-8 YEARS
9+ YEARS
Required
DO YOU OWN AN INSTRUMENT?
*
Yes
No
FIRST PREFERRED DAY AND TIME
*
Your answer
SECOND PREFERRED DAY AND TIME
*
Your answer
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