Student Registration Form
10503 Redosier Ct. Bethesda, MD 20814 Phone: (301) 530-7757 Fax: (301) 530-6203
www.musicalexpressions.com
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Student Name *
Age(s) *
Birthday(s) ex. mm/dd/yyyy *
Parent Name *
Address *
Billing Address (if different from above)
Mobile Phone
Home Phone
Do you text?
Please indicate your preferred day of the week and time range in order of preference:
For example:1 - Friday 4:15-8 p.m.
2 - Monday 3:30-6:45 p.m.
3 - Saturday 11:00am-3:30pm
1st Choice: *
2nd Choice: *
3rd Choice: *
4th Choice:
5th Choice:
6th Choice:
If you need a lesson on Sunday please let us know.
Instrument(s) *
Teacher(s)
Preferred length of lesson
I have read the Student Policies and I understand the content fully. By clicking YES, I agree to abide by the policies of Musical Expressions. *
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