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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

Summer Camps

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.

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 Consultation Fee*

Price:

Group Classes and Performance Ensembles

Spring Class and Ensembles*

Want to enroll in another class?

Yes

Spring Class and Ensembles*

Summer Camps

Summer Camps*

Want to enroll in another camp?

Yes

Summer Camps*

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

Summer Camps

Private 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 Consultation Fee*

Price:

Group Classes and Performance Ensembles

Spring Class and Ensembles*

Want to enroll in another class?

Yes

Spring Class and Ensembles*

Summer Camps

Summer Camps*

Sibling Discount! $50 off an additional sibling.

Want to enroll in another camp?

Yes

Summer Camps*

Sibling Discount! $50 off an additional sibling.

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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Phone

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Registration

Student Information

For Students 17 years old and younger.

Parent or Guardian contact

Emergency Contact Information

Class Type

Private Lessons

Group Classes and Performance Ensembles

Summer Camps

Additional Student Information

Private Lessons

Group Classes and Performance Ensembles

Summer Camps

Payment

Payment Details

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