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2007-2008 Music School Registration Form

(NOTE:  An asterisk (*) - denotes a required field)

If you are enrolling more than one student or require lessons for more than one instrument, please click on the "Submit & Enroll" button below to continue registration.  You will be redirected back to the registration page after initial tuition package is processed.  Please note:  a separate registration form is required per student, per instrument.

Session Information:

Check all that apply*:

  Spring     Summer     Fall

     New Student     Re-registration

Student Information:

Last Name* First Name* Gender*: Male Female
School* Grade* Date Of Birth (MM/DD/YY)*

Address Line 1*

Address Line 2

City, State, Zip*

Telephone (Primary)*

Telephone (Secondary)

E-mail Address

Parent / Guardian Information:

Last Name* First Name* Relationship*

Work Phone

Company Occupation

Second Parent / Guardian Information:

Last Name First Name Relationship

Work Phone

Company Occupation

General Information:

Instrument*

Skill Level:*: None Basic Intermediate Advanced
N.Y.S.S.M.A. level (Optional - NY residents only): N/A 1 2 3 4 5 6
Does student currently Own or Rent a working instrument?*: Own Rent None

How did you hear about The Amadeus Conservatory of Music?*

        Other:

 

Email us

if the links above do not work on your browser, please print the form and fax or send it to us.

(631)968-0940 fax

1408 Penataquit Ave Bay Shore, NY 11706


 
Click here to visit us at www.amadeuspianos.com
 
 
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