Student's  Name*    
 (last)
 (first)
Parent's  Name*    
 (last)
 (first)
    CLASS/LESSON PRE-REGISTRATION
   KAREN AMLAW MUSIC
            (Private Lessons for all instruments except voice are offered both virtually & in-person (your 
            choice). Voice / Singing Lessons and Group Classes continue to be held online via ZOOM)

Cell Phone    
Address*    
Home Phone*    
Student's Birthdate*   
Other Contact Info.   
Email* 
Program of interest
   
How did you hear about this program?
   
Comments
(If you are interested in a particular teacher please note that here)

(mm/dd/yy)
(You should instantly receive a confirmation of your pre-registration).
Days Available

Please pre-register separately for different programs and note additional interests in comments below.
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Please enter a second email below if someone other than you will be responsible for scheduling, payments, etc.
Time Possibilities*
(Please comment on your available times - e.g., doesn't matter, weekdays must be after 5:00PM, can do before 4:00 PM, etc.  This will help in planning new classes.)

Type of Learning Desired
Friends
Other Karen Amlaw Music students
Kids' Expo
Newspaper
Walk-in/drive by
Internet search
Teacher recomendation
Program ad
Patch newsletter/online
Monday
In-PersonVirtual
Tuesday
Wednesday
Thursday
Friday
Saturday