Shattuck-St. Mary's Music Academy Student Information Form
* Required
Email address
*
Your email
Parent/Guardian First Name
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Your answer
Parent/Guardian Last Name
*
Your answer
Parent/Guardian 2, First Name
Your answer
Parent/Guardian 2, Last Name
Your answer
Student's First Name
*
Your answer
Student's Last Name
*
Your answer
Student Date of Birth
*
MM
/
DD
/
YYYY
Home Address (number, street)
*
Your answer
City
*
Your answer
ZIP
*
Your answer
Student's Instrument or Voice Type
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Your answer
How many years has the student studied this instrument?
*
Choose
0
1
2
3
4
5
6
7
8
>8
What other instrument, if any, has the student previously studied? (If none, write "none".)
*
Your answer
How many years has the student played this other instrument?
Choose
1
2
3
4
5
6
7
8
>8
In what other musical groups or organizations is the student involved, if any? (e.g. school band, orchestra, church band, choir)
Your answer
With which musical groups or organizations is the student hoping to become participate, if any? (e.g. school band, orchestra, chamber group)
Your answer
What specific goals do you/the student have, if any? (e.g. musical career, play a certain piece, local competition, school talent show)
Your answer
Is there anything else you'd like to tell us about your student?
Your answer
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