Summer Registration Form
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indicates required fields
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Applicant's First Name:
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Applicant's Last Name:
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Parent or Legal Gaurdian's Name(s):
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Mailing Address (Street or PO Box):
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City:
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State:
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Zip Code:
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Home Phone:
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Work Phone:
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Cell Phone:
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E-mail address:
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Age (if minor):
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Gender:
Male
Female
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Grade in Fall '08:
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Number of classes/tuition applying for:
6 out of 10 summer classes $204.00
7 out of 10 summer classes $238.00
8 out of 10 summer classes $264.00
9 out of 10 summer classes $297.00
10 out of 10 summer classes $320.00
Blast off with Pinao! $195.00
Blast off with Piano Jr.! $150.00
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Type of class applying for:
Piano
Voice
Guitar
Write your own song!
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Please indicate the weeks you prefer for class:
June 16th - June 21st
June 23rd - June 28th
July 7th - July 12th
July 14th - July 19th
July 21st - July 26th
July 28th - August 2nd
August 4th - August 9th
August 11th - August 16th
August 18th - August 23rd
August 25th - August 30th
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Please indicate the payment method you would like:
Pay by check to our payment office
Pay using PayPal (debit, credit, e-check)
Please indicate the days and times you perfer:
Please voice any questions or concerns here: