Student Registration Form Name of Student * First Name Last Name Address Address 1 Address 2 City State/Province Zip/Postal Code Country Date of Birth MM DD YYYY Musical Instrument * Which instrument would you like to learn? Piano/Keyboard Guitar/Bass/Ukulele Voice Violin Drums Saxophone/Clarinet Flute Other Time/Date Availability * What day and time of the week would you be available to have a lesson? Anything else we should know about? Parent/Guardian Information Name * First Name Last Name Phone * (###) ### #### Email * Thank you!
