Rouse Band Private Lesson Enrollment

Parents: Before enrolling your child, please read all information, policies, responsibilities, and guidelines prior to submitting this form. This information can be found on the "Information" tab under private lessons on the menu above. Thank you!
General Information
Name of Primary Parent *

First Name Last Name
Address *

Street Address

Street Address Line 2

City

Postal / Zip Code
Home/Cell Phone *

Area Code Phone Number
Work Phone *

Area Code Phone Number
Parent Email *
Student Name *

First Name Last Name
Student Grade in School *

9 10 11 12
Student Instrument *
Lesson Teacher Preference *
Lesson Teacher (if selected "Other" from above)
Your preference for a lesson time is: *

During the school day (band class) Before school After school Virtual/Zoom
Financial Aid Information
Would you like to apply for financial aid? *

Yes, I would like to receive an application No
Final Step
My child has permission to participate in the Leander ISD Private Lesson Program. I have read the information regarding this program, and I agree to all conditions for participation. I will not hold the Leander ISD or any of its staff liable in the event of default by a private instructor.
Electronic Signature of Primary Parent or Guardian *
Date of Submission *

Month Day Year
Should be Empty:

General Information