Music Class Interest Form
Fill out the form carefully for registration
Student Name
*
First Name
Last Name
Student Age
*
Please Select
2
3
4
5
6
7
Class Selection
*
Please Select
- Kinder - Monday 4pm (ages 4-6)
- PreK - Tuesday 11am (ages 2-4)
- Kinder - Tuesday 12pm (ages 4-6)
- PreK - Thursday 11am (ages 2-4)
- Kinder - Thursday 12pm (ages 4-6)
Other classes/workshop:
- Homeschool Workshop - FREE 1st Thursday each month 12pm
- Drum/Percussion Fundamentals - Thursdays 1:30pm (any age)
- Private Lessons - Any age, instrument
- Songwriter Workshop Summer 2025
- Publishing Workshop Summer 2025
Additional Info/Services offered:
- Piano Tuning/Repair
- Instrument Stringing/Repair
- Live Events
- Recitals
Gender
Please Select
Male
Female
N/A
Primary Parent(s) Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary Parent Name
*
First Name
Last Name
Primary Email
*
example@example.com
Parent Mobile Number
*
Phone Number 2
Additional Comments (please include preferred instrument if any)
Submit
Should be Empty: