Music Lesson Registration

For Theory Lessons, click here.

1. Student Information

First Name (required)

Last Name (required)

Middle Initial

Age Today

Address (required)

City (required)

Province (required)

Country (required)

Postal Code (required)

Phone Number (required)

Alternate Phone Number

Email (required)

2. Emergency Contact

Last Name

First Name)

Phone Number

Relationship

3. Student's Musical Background

Instrument

Music Grade

Additional Comments Regarding Musical Background and Training

4. Program Choice

Instrument

Theory Course(s)

School Location