INSTRUMENTAL MUSIC ENROLLMENT FORM NAME OF

INSTRUMENTAL MUSIC ENROLLMENT FORM
NAME OF STUDENT _________________________________________________________
PARENT/GUARDIAN _________________________________________________________
MAILING ADDRESS __________________________________________________________
______________________________ ZIP CODE___________________
HOME PHONE ________________________ BUSINESS PHONE ______________________
PRESENT SCHOOL ____________________ PRESENT GRADE ______________________
PRESENT HOMEROOM TEACHER ______________________________________________
SCHOOL WHICH STUDENT WILL ATTEND NEXT YEAR __________________________
INSTRUMENT PREFERENCE ___________________________________________________
PREVIOUS INSTRUMENTAL EXPERIENCE ______________________________________
______________________________________________________________________________
______________________________________________________________________________
I am interested in enrolling my child in the INSTRUMENTAL MUSIC PROGRAM for the
____________________ school term and understand that he/she must have an instrument in
good playing condition when school opens.
Parent’s Signature _____________________________
Date ___________________________
INSTRUMENTS MAY BE RENTED FROM ANY OF THE MUSIC STORES THROUGHOUT THE
COUNTY
FINANCIAL ASSISTANCE WILL BE PROVIDED FOR THOSE WHO QUALIFY.