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Registration Form 2017-18

Student's Name:*
Registering for:*
Name of Group Class:

Please check those that apply; also, fill out the Private Lesson Scheduling Form and/or the Chamber Music Scheduling Form.

Month/year of birth
School Grade (2017-18):
Home address:*
Home Phone:
Emergency, First Call Phone:*
Primary Parent Contact:*
Primary Parent E-mail:*
Primary Parent Home Phone:
Primary Parent Work Phone:
Primary Parent Cell Phone:
Secondary Parent Contact:
Secondary Parent E-mail:
Secondary Parent Home Phone:
Secondary Parent Work Phone:
Secondary Parent Cell Phone:
Alternate Contact:
Alternate Contact E-mail:
Alternate Contact Home Phone:
Alternate Contact Work Phone:
Alternate Contact Cell Phone:

I have read and understood the WSM 2017-18 Attendance/Make-Up Policies. My electronic or written signature below indicates my agreement to be bound by these policies.

Type your name to agree:*
Word Verification:
Violin Student

“Sharon is an outstanding teacher—she provides excellent instruction and support for her students, while creating an environment in which they continue to love playing the violin!”

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