Student's Name                                                                                                                  Birthdate                                                                

Complete Address

Home Phone                                  Mom's cell                              Dad's Cell                                Student's Cell

School Grade                             School

Parents' Names 

Email Address

Please indicate your first, second, and third choices for lesson times.  The more choices you provide, the more easily and quickly the scheduling can be completed.  Weekend lessons are 
NOT available.

First Choice:                                Second Choice:                                    Third Choice:
Day                                              Day                                                    Day
Set Tunes

Complete the following form.
​Earliest Time
​Earliest Time
​Earliest Time
Latest Time
Latest Time
Latest Time
I am enrolling for the following lesson option: