STUDENT REGISTRATION FORM

Date: _______________

Student’s Name: ______________________________________________

Student’s Mailing Address: ______________________________________

City: ______________________  State: _________  Zip Code: _________

Date of Birth: ____________________  Age: _________  Sex: _________

Student E-mail Address: _______________________________________

Billing Name: ________________________________________________

Address: ___________________________________________________

City: ______________________  State: ________  Zip Code: _________

Home Phone: __________________  Cell Phone: __________________

E-mail Address: _____________________________________________

Name of Guardian: ___________________  Relationship: ____________

Home Phone: ___________________  Cell Phone: _________________

Emergency Contact: __________________  Phone: ________________

Why do you want vocal lessons? _________________________________

__________________________________________________________

Musical experience: __________________________________________

Favorite singers: ____________________________________________

Favorite types of music: _______________________________________

Parent’s favorite types of music: ________________________________