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Joyful Voice Single Lesson Registration Form
38
Questions
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1
Are you registering for the first time?
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YES
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2
Your Name
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First Name
Last Name
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3
Are you registering for someone else?
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4
Are you registering a student under the age of 18?
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YES
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5
Student Name
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First Name
Last Name
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6
Student Age
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7
Parent/Guardian Name
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Mr.
Mrs.
Ms.
Mr.
Mr.
Mrs.
Ms.
Prefix
First Name
Last Name
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8
Will there be any other adult who will be picking up student from lessons?
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YES
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9
Additional Adult Name
*
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Mr.
Mrs.
Ms.
Mr.
Mr.
Mrs.
Ms.
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First Name
Last Name
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10
Additional Adult Phone Number
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11
What is the relation of the Additional Adult to the Student?
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12
Do you have additional contact you would like to add?
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13
Additional Contact Name
*
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Mr.
Mrs.
Ms.
Mr.
Mr.
Mrs.
Ms.
Prefix
First Name
Last Name
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14
Additional Contact Phone Number
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15
What is the relation of the Additional Contact to the Student?
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16
Your Email
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example@example.com
Confirm Email
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17
Your Phone Number
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18
Your Address
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Street Address
Street Address Line 2
City
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Please Select
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Please Select
Afghanistan
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Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
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Kiribati
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South Korea
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Kuwait
Kyrgyzstan
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Latvia
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Lesotho
Liberia
Libya
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Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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19
Experience Level
Beginner
1-2 years
3-5 years
6+ years
Professional
Beginner
Beginner
1-2 years
3-5 years
6+ years
Professional
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20
Music Experience
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21
Would you like to upload your performance resume or bio?
Feel free to do so here.
Drag and drop files here
Select files to upload
Max. file size
: 10.6MB
Browse Files
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22
Goals and Ambitions
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23
Exceptionalities
Joyful Voice is committed to providing access to our programming for all populations, including children and adults with special learning needs. In order to best serve students with exceptionalities, we strive to maintain an open dialogue of clear communication with families and students about their specific needs. We will work with each family to identify appropriate beneficial resources and instructional activities and/or materials. To discuss unique needs, please email us at info@joyfulvoice.org or by phone at 803-803-5389.
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24
Preferred Availability
*
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Please indicated your availability for lessons.
Student Availability
Monday
Row 0, Column 0
Tuesday
Row 1, Column 0
Wednesday
Row 2, Column 0
Thursday
Row 3, Column 0
Friday
Row 4, Column 0
Saturday
Row 5, Column 0
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Student Availability
Row 0, Column 0
Student Availability
Row 1, Column 0
Student Availability
Row 2, Column 0
Student Availability
Row 3, Column 0
Student Availability
Row 4, Column 0
Student Availability
Row 5, Column 0
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25
Additional Comments
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26
Teacher Preference
Male
Female
No Preference
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27
Which instrument will you be studying?
*
This field is required.
Piano
Voice
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28
Do you have an additional student to register?
*
This field is required.
If so, please select the "10% Dual/Family Membership" option in checkout.
YES
NO
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29
Additional Student Information
First Name
Last Name
Student Age
Please Select
Beginner
1-2 years
3-5 years
6+ years
Professional
Please Select
Please Select
Beginner
1-2 years
3-5 years
6+ years
Professional
Experience level
Additional Music Experience
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30
Additional Student Music Experience
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31
Additional Student Goals and Ambitions
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32
Additional Student Exceptionalities
Joyful Voice is committed to providing access to our programming for all populations, including children and adults with special learning needs. In order to best serve students with exceptionalities, we strive to maintain an open dialogue of clear communication with families and students about their specific needs. We will work with each family to identify appropriate beneficial resources and instructional activities and/or materials. To discuss unique needs, please email us at info@joyfulvoice.org or by phone at 803-803-5389.
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Normal
Small
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Created with Sketch.
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33
Is Additional Student availability the same as first student?
*
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YES
NO
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34
Additional Student Availability
*
This field is required.
Please indicated your availability for lessons.
Student Availability
Monday
Row 0, Column 0
Tuesday
Row 1, Column 0
Wednesday
Row 2, Column 0
Thursday
Row 3, Column 0
Friday
Row 4, Column 0
Saturday
Row 5, Column 0
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Student Availability
Row 0, Column 0
Student Availability
Row 1, Column 0
Student Availability
Row 2, Column 0
Student Availability
Row 3, Column 0
Student Availability
Row 4, Column 0
Student Availability
Row 5, Column 0
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35
Additional Student Teacher Preference
Male
Female
No Preference
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36
Additional Student Instrument
*
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Piano
Voice
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37
User Agreement
*
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38
Please verify that you are human
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