Arkansas Center for Music Education Registration Form - 2018-19
THIS IS THE OFFICIAL REGISTRATION FORM FOR ACME. All students must complete this form at least once and must submit any changes to contact information as they occur. If you complete this form, you will not be required to complete the paper counterpart. However, your signature will be required on our Permission to Publish form, which allows us to include your student in pictures and/or videos promoting our classes. (If you do not wish to have your or your child's image used, you have the right to refuse to sign without repercussion.)
Student Name (format as Lastname, Firstname)
Date of birth
Parent name (if applicable)
Mailing address (please include city and zip)
Please check your preferred method of primary contact. (We use
to message classes - the option you select here will be entered in this message system)
Has student had any type of musical instruction or training by a professional?
If so, list type of instruction (voice, piano, guitar, string instrument, etc), length of time taking instruction, and instructor.
Student's current grade (if applicable)
Where does student attend school?
Please check the class(es) for which student is registering for:
PreK Music (ages 18 mo - 4 yrs)
Homeschool Elementary 1 (ages 5-7)
Homeschool Elementary 2 (ages 8-12)
Voice 1 (ages 7-12)
Voice 2 (ages 13 to adult)
Beginning 1 Orchestra
Beginning 2 Orchestra
River Valley Treble Chorus (ages 8-14)
The Community Festival Chorale
Wee Children's Musical Theater (ages 4-7)
Children's Musical Theater (ages 8-15)
West Central River Valley Community Band
If you checked "The Community Festival Chorale", please select the part you are most comfortable singing.
If you selected "West Central River Valley Community Band", please list the instruments you play (list primary first).
Does student have other family members that will also be participating in any of the music classes offered by ACME?
Does the student have any special needs or difficulties (i.e. ADHD, learning disabilities, Autism, etc.)? (Note: We ask this so that we can made any necessary modifications to our lessons and instruction methods to assist the student to have the most success possible. Please be as specific as necessary.)
How did you hear about the classes for which you are registering?
Do you or a supporting family member have a craft or skill you would be willing to volunteer to ACME if there was a need? (music, construction, accounting, clerical, electrical, sewing, etc.)
If you selected yes to the previous question, please list the skills or crafts.
Are you willing to volunteer with ACME?
If you checked yes, please check the tasks for which you are willing to volunteer:
distribution of posters/help with promotions
ushering/working concerts (food sales, admissions collection, etc.)
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