SAFE HOUSE MUSIC ACADEMY
919 N. Keowee Street, Suite 101
Dayton, Ohio 45404
info@safehousemusicacademy.com
www.safehousemusicacademy.com
(855) 701-9099
STUDENT REGISTRATION Form
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EMERGENCY CONTACT DETAILS
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Emergency Contact
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EDUCATIONAL INFORMATION
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Name of Attending School
What Grade are you in?
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After School Activities
Graduating Year (High School Students)
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ACADEMY INFOMRATION
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Select A Program
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Music Production
Videography Basics
Learn to Fly Drones
Songwriting
Audio Engineering
Building Websites
Podcast Production
Basic Photography
Select Two Programs That Interest You
Audio Engineering
Podcast Production
Video Production
Songwriting
Introduction to Drones
Website Design
Music Production
Basic Photography
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Application Fee
Payment is due 3 days prior to the start of the class. Please check which payment method you will be using once your student is approved.
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