Grace Notes Violin Studio Private Lessons and
St. Francisville Strings Registration

All fields are required unless otherwise indicated.

Student Name:

Please enter the student's name.

Date of Birth: Age:

Please enter the student's birth date - mm/dd/yyyy format.

Please enter the student's age.

Parent or Guardian (if applicable):

Please enter the name of the Parent or Guardian.

Home Phone: Work Phone: Cell Phone:

Please enter 10 digits for you phone number in ###-###-#### format.

You MUST enter at least one phone number.

Mailing Address:

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Address 2 (Apt #, Suite, etc.): (optional)

City: State: Zip Code:

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Please enter your State.

Please enter your Zip Code.

Email Address:

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Please select if you are:

New Student: Returning Student:

Please select if you are a New Student or a Returning Student.

Please select the which instrument you are registering for:

Violin Viola Cello Bass Music Composition
Fiddle Guitar Harp Piano

Please select the which instrument you are registering for.

Please indicate at least two days of the week you could have a lesson on. Not all instructors are available on weekends, so please check instructor's teaching schedule prior to registering. St. Francisville Strings only offered on Wednesday for the Fall 2009 session.

Monday Tuesday Wednesday Thursday Friday
Saturday Sunday

Please select AT LEAST TWO preferences for the day of the lesson.

You may not select more than two days. Thank you.

Please select the length of the lesson you are registering for:

30 minutes 45 minutes 60 minutes

Please select the length of the lesson you are registering for.

Please indicate a range of times on the days indicated in which you could attend your lesson. Please rank them in the order of preference:

Please indicate a range of times on the days indicated in which you could attend your lesson.

Please indicate any prior or current string instrument experience:

Please enter student's prior or current string instrument experience.

Prior Teachers:

Please indicate Prior Teachers. Put N/A or NONE in Not applicable.

Please indicate any other musical experience outside of stringed instrument instruction:

Please indicate any other musical experience outside of stringed instrument instruction.

Check here if you are interested in group ensemble study: Yes No

Please indicate if you are interested in group/ensemble study.

Please check here if you wish to order a New Student Package:

Please check here if you wish to order an Instrument Rental Package:

Please let us know how you heard about Grace Notes: (optional)

Submission of this enrollment form is commitment to the entire session, no exceptions.

I understand when I submit this form, this indicates that I have read and agreed to all policies in the handbook provided to me, and agree to all terms and conditions outlined in the handbook.