Arkansas Center for Music Education Registration Form
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.)
Today's Date *
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Student Name (format as Lastname, Firstname) *
Your answer
Date of birth
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Parent name (if applicable)
Your answer
Email address
Your answer
Mailing address (please include city and zip) *
Your answer
Best phone *
Your answer
Please check your preferred method of primary contact. (We use remind.com to message classes - the option you select here will be entered in this message system) *
Required
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.
Your answer
Student's current grade (if applicable)
Your answer
Where does student attend school?
Your answer
Please check the class(es) for which student is registering for: *
Required
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).
Your answer
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.) *
Your answer
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.
Your answer
Are you willing to volunteer with ACME?
If you checked yes, please check the tasks for which you are willing to volunteer:
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