1.Student's Full Name & Age:

2.Parent/Guardian Name: (First & Last)

3.Phone Number:

4.Instrument of Choice:

Violin

Viola

Cello

Guitar

Ukulele

Vocal

Piano

Other (please specify)

5.How long has the student played their chosen instrument?

6.If the student has taken lessons on their chosen instrument, list their teacher's name below. If they haven't had any formal lessons, describe their musical experience below.

*7.Do Tuesday’s 5:30-6:30 PM work for you this summer? We may have other options for weekly rehearsal times if needed!(Required.)

Yes

No