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2018-2019 CPS Encore Lesson Registration Form
Section 1: Student Information
First Name *
Your answer
Last Name *
Your answer
Untitled Title
School Attending in Fall 2018 *
Grade in Fall 2018 *
Student Experience *
Select your instrument: *
Section 2: Parent Information
Select Lesson Length: *
Parent/Guardian 1 Last Name *
Your answer
Parent/Guardian 1 First Name *
Your answer
Parent/Guardian 1: Best Telephone Number to be Reached? *
Your answer
Parent/Guardian 1: Email Address *
Your answer
Parent/Guardian 2 Last Name *
Your answer
Parent/Guardian 2 First Name *
Your answer
Parent/Guardian 2: Best Telephone Number to be Reached? *
Your answer
Parent/Guardian 2: Email *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
After you hit submit, please click on the link to make your tuition and registration payment (Registration fee is included in the tuition payment).
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