Expertise • Enthusiasm • Excellence

Registration

• New Student Enquiry Form
• Registration Form
• Summer Day Registration
• Private Lessons Scheduling
• Chamber Music Scheduling
• Policies

New Student Enquiry Form

Please complete and submit the form below so we can get to know you a little better. Once your form is submitted, call our office at (508) 358-7835, to schedule a free consultation with our Director, Penny Wayne-Shapiro, who will help you choose the best program or instructor to match your needs and reach your goals.

Student's Name(*)

Please let us know your name.

Month/Year of Birth (not needed for adult students)

Enter the student's month and year of birth.

Name of Parent/Guardian (not needed for adult students)

Please enter the name of the Parent to be contacted.

E-mail (of Parent/Guardian or Adult Student)(*)

Enter the email address of contact person.

Preferred Phone(*)

Please enter your preferred phone number (XXX-XXX-XXXX).

Secondary Phone

Enter your secondary phone number in the form XXX-XXX-XXXX

Address(*)

Enter your home address including STREET ADDRESS, CITY, STATE, and ZIPCODE.

City(*)

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State(*)

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Zip Code(*)

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Musical Experience(*)

No experience

Music Together/Kindermusik

Dalcroze Eurhythmics

Group Piano/Keyboard

Music Theory/History

Private Lessons

Orchestra or Ensemble program

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Area(s) of Interest(*)

Early Childhood (Ages 0-5)

Group Class (Ages 5-8)

Private Lessons

Ensembles

Not sure

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What are the student's musical goals and ambitions, if applicable?

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What are the musical goals and ambitions of the parent/guardian(s) for the student, if applicable?

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What kind of teaching style to you think will work best for the student?

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Is there anything else you think we should know in order to effectively place the student (e.g. learning, style, special needs, gender preference of teacher)?

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Please list other interests the student has (e.g. sports, dance)

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Please list the days and time ranges the student is available for lessons

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How did you hear about Wayland School of Music?(*)

WSM website / Internet search

Brochure/flyer

Email

Catalog/Calendar in the mail

Newspaper

Heard from a friend

Heard from a music teacher

WSM Facebook page

Other

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