2008 Fall Renewal Registration Form
Date
Parent Name
Address City/State/Zip Phone Fax Email
Student Age Instrument Student Age Instrument Student Age Instrument
Select from one of the four choices below, then fill in any 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 , and/or
time (list your preferences in the box).
No, I'm not continuing lessons at this time. Please call me.
Additional Comments
E-mail address: