DCS Voice Lesson

Km 10 Plain View Village Sasa Davao City

Music Registration Form
09097835483 • eragrhey21@gmail.com School Year 2014 –2015

Music Registration
Please complete this form and return. Date

To register for any Music program, please complete the form at right and return to:
CONTACT INFORMATION

DCS Voice
Student name Age (N/A for adults)

Local Address Male Female

Lesson City/State/ZIP

Home phone Cell phone

RESPONSIBLE FOR BILLING (Non-applicable for Adult Students)

Mother’s name Father’s name

Address same as above? Yes No*

* If no, provide alternative address:

City/State/ZIP

Mother’s place of work Mother’s work phone

Father’s place of work Father’s work phone

Email address

EMERGENCY INFORMATION (Non-applicable for Adult Students)

Emergency contact person

Phone Relationship to student

MUSICAL STUDY

Indicate Instrument you wish to study in PRIVATE LESSONS:

Will your lessons be: 9am-11am 1am-3pm 3pm-5pm

If you are enrolling in group lessons, list name and time:

Are you a: New student Returning student Number of years of previous instruction:

Name of previous teacher(s):

The best thing about studying at The Music Academy is

How did you learn about The DCS Voice Lesson?
Mr. Goldstein’s instruction…he takes time, has patience
Friend/Neighbor/Family Newspaper Public Radio
and really works at my level of ability to help me improve Studied here before Website Other, please name:

my skills and self-confidence.

An annual Registration Fee of php350 is required of all PRIVATE LESSON students and Total enclosed
                                                                                                    — Rhey. must be paid along with Tuition. The Registration Fee for additional students from the $
same family is 300php. A 350 fee per semester will be applied to those accounts choosing the
Two Payment Plan option.

I understand that . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . is enrolling for . . . . .

. . . weeks.
Ê I have read and agree to the enrollment policies of The Music Academy.