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Student Information

Student Name*

First Middle Initial Last

Date of birth*

Gender*

Email address*

Primary phone number*

Secondary phone number

Home address*

Street Address Address Line 2 City State Zip Code

How did you first hear about CMS?*

What is their Workplace or School?

Other*

For Students 17 years old and younger.

Parent or Guardian name

First Last

Contact info same as student?

Yes

Parent or Guardian contact

Address*

Street Address Address Line 2 City State ZIP Code

Phone number*

Work phone number

Emergency Contact Information

Emergency contact name*

First Last

Emergency phone number*

Class Type

Are you interested in individual lessons, group classes, performance ensembles, music therapy or summer camps?*

Individual Lessons

Music Therapy

Group Classes

Performance Ensemble

Private Lessons

You will be called to schedule an appointment with Paul Waara. Student(s) will be matched with an instructor, and if you are choosing to take voice lessons, you may be asked to sing briefly, at the time of your interview. Your monthly payment will be determined by the lesson day. Your first payment must be received at least 1 day before the first scheduled lesson.

Individual Adaptive Lessons

I am interested in Individual Adaptive Lessons.

Our board-certified music therapists offers the following individual adaptive lessons that are inclusive for all people with varying abilities for the following instruments: piano, voice, guitar, ukulele, electric bass, saxophone, and clarinet.

What would you like to study?*

Lesson Length*

All beginners will be assigned a 30-minute session.

When are you available for lessons? Choose all that apply.*

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

What time of day?*

Morning

Afternoon

Evening

Teacher preference, if known

How many years of previous study have you had?

Please list any medical conditions that may affect study.

Registration Fee*

Price:

Music Therapy

Once the registration form and fee have been received, you will be contacted to schedule your sessions and payment schedule. Client(s) will be matched with a therapist within two weeks of registering for sessions. Your monthly payment will be determined by the session day. Your first payment must be received at least 2 business days before the first scheduled session.

What type of session are you interested in?*

Session Length*

When are you available for sessions? Choose all that apply.*

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

What time of day?*

Morning

Afternoon

Evening

Please list any diagnoses and/or conditions related to service.*

Please upload supporting documentation.

Drop files here or

Max. file size: 512 MB.

IEP, Transition Plan, Life Plan, etc.

Registration Fee*

Price:

Music Therapy Consultation Fee*

Price:

Group Classes and Performance Ensembles

Winter 2025 Class and Ensembles*

Available Soon!

Want to enroll in another class?

Yes

Winter 2025 Class and Ensembles*

Available Soon!

Want to register another student? If not, click "Next" to continue.

Yes

Additional Student Information

Name*

First Middle Initial Last

Date of birth*

Month

Day

Year

Gender*

Are you interested in individual lessons, group classes, performance ensembles, music therapy, or summer camps?*

Individual Lessons

Music Therapy

Group Classes

Performance Ensemble

Private Lessons

Individual Adaptive Lessons

I am interested in Individual Adaptive Lessons.

What would you like to study?*

Lesson Length*

All beginners will be assigned a 30-minute session.

When are you available for lessons? Choose all that apply.*

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

What time of day?*

Morning

Afternoon

Evening

Teacher preference, if known

How many years of previous study have you had?

Please list any medical conditions that may affect study.

Registration Fee*

Price:

Music Therapy

What type of session are you interested in?*

Session Length*

When are you available for sessions? Choose all that apply.*

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

What time of day?*

Morning

Afternoon

Evening

Please list any diagnoses and/or conditions related to service.*

Please upload supporting documentation.

Drop files here or

Max. file size: 512 MB.

IEP, Transition Plan, Life Plan, etc.

Registration Fee*

Price:

Music Therapy Consultation Fee*

Price:

Group Classes and Performance Ensembles

Winter 2025 Class and Ensembles*

Available soon!

Want to enroll in another class?

Yes

Winter 2025 Class and Ensembles*

Available Soon

Payment

Annual registration fee of $30 per student (no registration fee for summer camps, group class & performance ensemble students)

Payment Details

Privacy*

I have read and agree to abide by the CMS Policies and Procedures.

Do you give Community Music School Permission to use your photo for publicity and media purposes?*

Signature of student (or parent/ guardian if student is under 18)*

By typing your name, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.

Date*

Month

Day

Year

Credit Card

Card Details

Cardholder Name

Total fees charged today

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Student Policies & Procedures 2024-2025

Registration

Student Information

For Students 17 years old and younger.

Parent or Guardian contact

Emergency Contact Information

Class Type

Private Lessons

Music Therapy

Group Classes and Performance Ensembles

Additional Student Information

Private Lessons

Music Therapy

Group Classes and Performance Ensembles

Payment

Payment Details

Ready to make some noise?

Student Policies & Procedures 2024-2025

Register

Registration

Student Information

For Students 17 years old and younger.

Parent or Guardian contact

Emergency Contact Information

Class Type

Private Lessons

Music Therapy

Group Classes and Performance Ensembles

Additional Student Information

Private Lessons

Music Therapy

Group Classes and Performance Ensembles

Payment

Payment Details

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