REGISTRATION
STUDENT NAME __________________________ CONTACT NAME ___________________
ADDRESS ____________________________________________________________
TELEPHONE _________________________ EMAIL ___________________________
SCHOOL NAME/ GRADE/
or HOMESCHOOL __________________________ LEVEL __________________________
INSTRUMENT(S) __________________________ TUTORING ______________________
INSTRUMENT MEMBER of NEEDED? __________________________ SCHOOLBAND? ____________________
PREFERRED DAY
for LESSON __________________________ or ___________________________
PREFERRED TIME
for LESSON _________________________ or ___________________________
SCHOOLBUS
DROPOFF NEEDED?__________________________ BUS #___________________________
COMMENTS ___________________________________________________________