Student Registration Form

The Music Academy

Student Information Form

Please complete the form below and click submit at the bottom of the form when you are finished. You may also telephone the Academy's office between the hours of 9:00-5:00 Monday - Friday to speak to Bobbi Jo Wilson regarding lesson openings. Summer hours are varied, if you call our office please leave message 931-484-6676 (Download the Summer 08 Kindermusik Camp Registration Form if you prefer, requires adobe PDF)

Parent(s)/Guardian(s):

Address:

City: State: Zip:

Telephone(s):

E-mail:

Student Name:

Age: Birth date:

PLEASE BE SURE TO COMPLETE ALL FOUR SELECTIONS!!!

Please indicate if you:

Please choose your area of study:

If you are registering for the Kindermusik® program, please choose a level.

Please choose your desired lesson length:

If requesting private study, please provide some information about your previous musical studies if any:

Instrument:

Teacher:

Length of study:

Instrument:

Teacher:

Length of study:

Instrument:

Teacher:

Length of study: