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.
* 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
