Registration Form

*Name and home phone number are required.

*Student's Name: Age:

If under 18, parent/guardian Name(s):

Street Address:

City: State: Zip:

*Home Phone: Daytime Phone:

E-mail:

Student is: New Student Transfer Student

If transfer student, number of years previously studied:

Does the student play any other musical instrument? Yes No

If the student is under 18:
Does any family member play an instrument? Yes No
What school does he/she attend?
What is his/her grade in school?
What after-school activities does he/she participate in?