Student's Name*
(last)
(first)
Parent's Name*
(last)
(first)
CLASS/LESSON PRE-REGISTRATION
KAREN AMLAW MUSIC
Cell Phone
Address*
Home Phone*
Student's Birthdate*
Other Contact Info.
Email*
Program of interest
How did you hear about this program?
NEMA transfer students please note your NEMA experience below in the comments.
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.
* Required field
(apt. #)
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
Due to issues with the transmission of data from these pre-reg. forms to KAM please send your inquiry by taking a screen shot of this completed form and emailing it to [email protected] - then hit submit below. This will allow us to see how many applications are being lost and ensure that we at KAM are promptly responding to your inquiries.
Thank you for your patience as we resolve this internet issue.
You will receive a confirmation email from KAM within 48 hours.
