Scrollworks Registration Summer 2023

Summer 2023 Registration
1. Basic Info
Student Full Name*

First NameLast Name
Student Date of Birth*

MonthDayYear
Student's Race/Ethnicity
This field is optional and will only be used in aggregate with all other responses .Accurate demographics help us attract and retain funding.
School Student will be Attending for Fall 2023
This field helps us determine broad socioeconomic data for reports to funders
Responsible Party Name*

First NameLast Name
Best Cellphone Number*

Area CodePhone Number
Responsible Party E-mail*
Please note that Scrollworks' primary means of communication is by email.
Please make sure your entry above is correct.
Student or Alternative E-mail (if notification desired)
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Please put special considerations or other info we should know in the comments box at the end.
Which lesson package do you want?*

3 lessons in June6 lessons in June and July
2. For The Youngest Musicians
Age 6 (as of June 1)

Instrument Explorer
Age 7 (as of June 1)

String Basics Violin
Does your 7-year-old have a violin?

Yes, I have my own instrumentYes, I have a Scrollworks instrumentNo, I don't have this instrument and will need to borrow.
3. For Everyone Else (Age 8+)
Primary Instrument
How many years of study on primary instrument?
Do you have your primary instrument?

Yes, I have my own instrumentYes, I have a Scrollworks instrumentNo, I don't have this instrument and will need to borrow.Theory doesn't need an instrument
Second Instrument (optional)
How many years of study on second instrument?
Do you have your second instrument?

Yes, I have my own instrumentYes, I have a Scrollworks instrumentNo, I don't have this instrument and will need to borrow.Theory doesn't need an instrument
Optional Instrument of Interest
(in case other lessons aren't available. We will contact you about this.)
4. Other Things We Need to Know
Any comments about the instrument(s) you have/need?
Please review calendar on the home page of our website. We do not offer make-up lessons if your child cannot attend.
Through our contract with the VSA at the Kennedy Center, students with a disability will be evaluated and considered for additional services at no cost to you.

Please indicate below if you believe your child is eligible for the VSA program.
My child is eligible for the VSA program.

YesNo
How did you hear about Scrollworks?
Comments:
Resgistration Fees for Summer 2023:
$60 per instrument for 6 lessons.
$40 per instrument for 3 lessons
Instrument deposit is $25
Minimum Fee:

prevnext( X )
USDThank you!
Should be Empty:

Summer 2023 Registration

1. Basic Info

2. For The Youngest Musicians

3. For Everyone Else (Age 8+)

4. Other Things We Need to Know