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