Course Registration Form

Registration Form for Group Lesson Grant

Criteria for being chosen for the program: Income guidelines in Under $50,000 per year Parents will have to provide the most recent tax year or proof of income or a letter from their current employer or unemployment, or benefit letter. The program is 12 weeks long. Each and every Sunday. There will be No Makeups for missed lessons. Fill out the form carefully for registration. Families will be notified to start via email and phone call/text. Lessons are held at Hawken Upper on Sundays and Saturdays. Ages 3 years old to 18 years old. Fill out one application per child. Call (216)645-9451 regarding questions.
Student Name*

First NameMiddle NameLast Name
Parent Name*

First NameLast Name
Student’s Birth Date

MonthDayYear
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student’s Gender
Mobile Number
Proof of income( two pay stubs)

Cancelof
Proof of income( tax return 2023)if not working

Cancelof
Proof of SNAP(EBT), Medicaid, cash assistance

Cancelof
Which group class are you interested in?

Beginners Ages 3-5 years at 11amBeginners Ages 6-13 at 12pmIntermediate Ages 6-14 years at 12:30pmNot sure and need a assessment
Parent’s E-mail
example@example.com
Signature

Powered by Jotform SignClear
Should be Empty:

Registration Form for Group Lesson Grant