Rivers School Conservatory Application Form
333 Winter Street, Weston, MA 02493 | (781) 235-6840 | www.riversschoolconservatory.com
When would you like to start lessons?
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Please Select
As soon as possible
This coming Summer (June-August)
This coming Fall (September-January)
This coming Spring (February-May)
Student Information
Student Name
*
Student Age
*
Birth Date
*
/
Month
/
Day
Year
Date
Gender
*
Male
Female
Non-binary
Prefer not to say
Instrument
*
Years Studied
*
Other Instruments
Current/Former Teachers
Address
*
City
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State
*
Zip Code
*
School
*
Current Grade
*
Please Select
PK
K
1
2
3
4
5
6
7
8
9
10
11
12
Adult
Parent/Guardian 1 Info
If you are an adult student, please just list your information here
Parent 1 Full Name
*
Parent 1 Salutation:
*
Mr.
Mrs.
Ms.
Dr.
Parent 1 Home Phone
Parent 1 Cell Phone
*
Parent 1 Email
*
Parent 1 Employer
Parent 1 Title
Parent/Guardian 2 Info
Parent 2 Full Name
Parent 2 Salutation:
Mr.
Mrs.
Ms.
Dr.
Parent 2 Home Phone
Parent 2 Cell Phone
Parent 2 Email
Parent 2 Employer
Parent 2 Title
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