HEAL Center For the Arts Pre-qualifying Form

Thank you for your interest in HEAL! Please fill out this short form so we can get to know your family better. This will help us ensure that our programs are the right fit and allow us to explore the best ways to support your child’s musical journey.

Date:

Student Full Name:*

Student Age:

Sex*

MaleFemale

Grade Level*

Instrument(s) Played

Student's email address:*

Parent or Guardian Full Name (if minor):*

Parent's email address:*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Are you enrolling more than 1 child?

YesNo

How many additional child are you looking to enroll?

123

Please provide the information for the second child.

2nd Student Full Name:*

2nd Student Full Age*

2nd Student Sex*

MaleFemale

2nd Student Grade*

Instrument(s) Played*

2nd Student Email Address*

Please provide the information for the third child.

3rd Student Full Name:*

3rd Student Full Age*

3rd Student Sex*

MaleFemale

3rd Student Grade*

Instrument(s) Played*

3rd Student Email Address*

Please provide the information for the fourth child.

4th Student Full Name:*

4th Student Full Age*

4th Student Sex*

MaleFemale

4th Student Grade*

Instrument(s) Played*

4th Student Email Address*

Tuition

($100/week per student)

HEAL Center for the Arts provides high-quality, immersive music education that includes:

Two 2-hour classes per week (Wednesdays and Thursdays - 4 hours total)
Access to over 50 performance opportunities per year
Access to HEAL's student portal
High-quality resources, materials, and mentorship

What Students Will Learn
HEAL’s year-round program teaches a rigorous curriculum rooted in jazz and contemporary music. Students will explore:

Music theory and history
Instrumental and vocal performance
Composition and songwriting'
Ensemble work and stage presence
Music technology and audio recording
Social Media Marketing and Platform usage
Marketing and branding for musicians
Music Business Acumen
Financial Literacy

Get a glimpse of what it’s like to be part of the HEAL family through this powerful compilation of student voices and experiences:

🎥 WATCH: Testimonial Compilation from HEAL Students

HEAL Center for the Arts is committed to making its programming accessible. A limited number of need-based scholarships are available each year to support families who qualify.

Please note that scholarship requests will require additional screening or documentation. Indicate below whether your student would need scholarship assistance to participate.

Do you require scholarship assistance?

YesNo

To ensure a smooth experience and uninterrupted access to HEAL programs, families are required to enroll in our subscription system through HEAL Center for the Arts website. This system helps streamline the payment process and ensures students remain fully engaged in all activities and resources.

You will receive an email soon with step-by-step instructions on how to complete your enrollment.

Preffered Payment Method:*

Credit/Debit CardBank Transfer

Preferred Billing Schedule*

Monthly Billing • $400 due on the 1st of each monthWeekly Billing • $100 due every MondayBi-weekly Billing • $200 due on the 1st of each month • $200 due on the 15th of each month

I certify that all information provided above is true and accurate to the best of my knowledge. I understand that by submitting this form, I am completing the first step in the pre-qualification process to express interest in HEAL Center for the Arts.

I acknowledge that I have reviewed the tuition costs. I also understand that my submission will be carefully reviewed, and a representative from HEAL will be in touch to guide me through the next steps.

I understand and agree to the terms outlined above and the pre-qualification process.

Yes

HEAL Center for the Arts

Payment Options