Renewal Registration Form 2010/2011 School Year
After you've completed this registration form, please return to Policies page for information about paying anuual registration fee.
Date
Parent(s) Name
Address City/State/Zip Home Phone Cell Phone FAX Email address
Student Age Instrument Student Age Instrument Student Age Instrument
Select from one of the four choices below, then fill in appropriate information:
Yes, I'm continuing music lessons with the same teacher at the same time & day.
Teacher: Day(s): Time.
Yes, I'm continuing lessons but I would like to change the day to , and/or
time to and/or teacher (list preferences in boxes).
No, I'm not continuing lessons at this time. Please call me.
Please write "yes" in the box if you are paying registration fee by check
Additional Comments